Hospital Deals Dipped in 2016

What the Affordable Care Act gave to the hospital sector, in the form of millions of more insured patients, it slowly took away, in the form of declining inpatient visits and growing competition from freestanding emergency rooms, ambulatory surgery centers and urgent care clinics. The ACA’s beneficial effects were largely played out by the third quarter of 2015, and by 2016, the thrill was gone. Hospital M&A slid slightly in 2016, according to our preliminary year-end data. Eighty-nine hospital deals were announced, down 13% compared with 2015. Spending was far higher than a year ago, reaching nearly $14 billion, a figure 47% higher than 2015’s combined total of $9.5... Read More »

The Hospital Market in the UAE Heats Up

Healthcare deals, particularly for hospitals, are heating up in the United Arab Emirates. On December 14, NMC Health, the country’s largest private healthcare company, announced its acquisition of Al Zahra Hospital in Sharja. Al Zahra is one of the largest private hospitals in the UAE, operating 137 active inpatient beds. It serves approximately 400,000 outpatients and 23,000 inpatient bed days per year. Its owner, Gulf Medical Projects Company, agreed to a purchase price of Dhiram2.1 billion, or approximately $571.7 million. That works out to nearly $4.2 million per bed, but if the claim that the hospital had $130 million in revenue in 2015, the revenue multiple of 4.4x... Read More »

Community Health Systems Starts Divesting Hospitals

It’s no secret that Community Health Systems (NYSE: CYH) has a $15 billion debt load, and that despite its spin-off of Quorum Health Corp. (NYSE: QHC) last April, its financial performance hasn’t improved. During the company’s third-quarter earnings call on November 1, CEO Wayne Smith said the company was in discussions to shed 17 of its 157 hospitals, as well as home health services and non-hospital real estate. The most recent deal following that call was announced on November 17. Community Health’s Spokane, Washington-based Rockwood Health System will become part of Tacoma, Washington-based MultiCare Health System, a not-for-profit system that operates five... Read More »

What U.S. Hospitals Are Acquiring in 2016

Hospital acquisitions have surged since the Affordable Care Act was passed in 2010. That year, 76 deals were announced, with a U.S. hospital or health system as a target. By 2012, 107 transactions were recorded for hospital targets, and that still stands as the highest number of deals per year. Only 2015 came close, with 102 hospital transactions. Through mid-November, there have been 79 deals announced with U.S. hospitals or health systems as the target. But what are U.S. hospitals acquiring for their own financial health? Other hospitals or health systems make up the majority of targets every year, of course.  So far this year, through mid November, 66 transactions... Read More »

October M and A Settles into Second Place

What’s a synonym for “slowdown?” We’re as tired of writing about monthly deal volume dropping off as you probably are of reading about it. But M&A activity in October 2016 can only be summed up as slackening, declining, decelerating. Preliminary deal volume is now at the second-lowest level of the year, just 112 transactions. Only January’s deal volume was lower, at 104 transactions. We may have a few additions to October’s total as the fourth quarter grinds on, but it’s not typical to find another 15 deals. Deal value also dropped off. At $12.8 billion, it ranks as the second-lowest level of spending for the year. July 2016 still holds the honor of being the slowest month for... Read More »

HCA Exits, SSM Health Enters OU Medical System

One for-profit company relinquishes ownership, and one not-for-profit takes over. That’s what happened on October 16, when HCA (NYSE: HCA) announced it was selling its ownership in the hospital operations of Oklahoma University Medical Center (688 beds) in Oklahoma City, and OU Medical Center Edmond. The University Hospitals Authority and Trust (UHAT), a private entity that was formed by the state, HCA and the University of Oklahoma, will pay HCA $750 million when the transaction closes in the first half of 2017. The company also agreed to terminate its lease of The Children’s Hospital at Oklahoma University Medical Center, as well as an associated joint operating agreement.... Read More »