Heard in the hallway

It is time, once again, for my dispatch from the hallways of the Non-Profit Health Care Investor Conference in New York.

I am not allowed past the hallway into presentations by top executives from large and financially strong health systems, who take questions from analysts and investors. The conference is sponsored by Citigroup, the Healthcare Financial Management Association and the American Hospital Association.

Here's some of what I learned this year by cornering executives in the hallway:

Among systems, there is a concentration on growth, and not just for hospitals.

Ascension Health, the largest U.S. not-for-profit health system, will seek to diversify geographically and across healthcare services, said Robert Henkel, president and CEO of the system. “We don't see the end of growth anytime soon,” he said.

Dignity Health has a robust merger and acquisition pipeline made possible by the system's restructuring, said Michael Blaszyk, Dignity's chief financial officer, chief corporate officer and senior executive vice president. Dignity Health, formerly Catholic Healthcare West, broke from the Roman Catholic Church earlier this year.

Catholic Health East, which is looking for greater scale, will target markets where it believes that growth is achievable, said Peter DeAngelis, its executive vice president and chief operating officer.

Intermountain Healthcare will increase its emphasis on owning or providing financial support for community clinics, said Albert Zimmerli, Intermountain's executive vice president and CFO.

Advocate Health Care, located in Chicago's active healthcare marketplace, is open to talks with hospitals and systems in its markets, said Dominic Nakis, Advocate's senior vice president, CFO and treasurer.

Geisinger Health System's recent growth—its January acquisition of Shamokin Area Community Hospital, followed a month later by Community Medical Center—created capacity to care for less-complex patients, said Kevin Brennan, executive vice president and CFO of the Pennsylvania system.

A poll of attendees on the final day of the New York conference found the top reason for acquisitions, mergers and partnerships was a desire for economies of scale. (Preparation for population health management ranked No. 2, followed by efforts to be a more significant player, and access to capital).

That same poll found a striking divide between health system officials and investors when it comes to the outlook for not-for-profit healthcare.

Roughly half of health system officials (51%) described the outlook as stable. Another 28% believed the outlook to be positive and 21% said it was negative.

Investors were far more pessimistic: 63% said the outlook was negative and 33% deemed it to be stable. Four percent had a positive outlook.

You can follow Melanie Evans on Twitter: @MHmevans.