That's what the large Roman Catholic and other not-for-profit systems will be saying when they relax in 1999 after several frenzied years of mergers and acquisitions.
The deals won't stop, but the pace will slow. In fact, the slowdown is already under way.
Hospital transactions are expected to be down by as much as 26% in 1998 over 1997, when 199 deals involving 312 hospitals -- 261 of them not-for-profit -- were publicly announced, according to Irving Levin Associates, a New Canaan, Conn.-based firm that tracks such deals.
Preliminary figures showed 146 transactions involving 332 hospitals -- 240 of them not-for-profit -- as of Dec. 28.
The prediction for hospital activity in 1999: The number of hospital mergers and acquisitions will stay flat or drop again, says Stephen Monroe, a partner at Irving Levin. "I don't think we're going to see a big spike upward," he says.
It will be interesting to watch how the new marriages work out once the honeymoon is over and how much these not-for-profit systems will act like for-profits.
Will they sell off money-losing facilities? Will they shutter others in communities where market share is weak?
Now that Columbia/HCA Healthcare Corp. has sold 21 of its hospitals to not-for-profit buyers, the phenomenon called "reverse conversion" should be in the news more often. A reverse conversion occurs when a not-for-profit buys a for-profit hospital, and the facility comes off the tax rolls.
A recent study showed that 100 for-profit hospitals converted to not-for-profit status between 1988 and 1995 (Oct. 5, p. 17).
We may see some uproar over these conversions as communities demand to know what they will get in exchange for lost property tax revenues. Local governments may resist efforts to take hospitals off the tax rolls and try to extract deals in exchange.
Hand-wringing will continue over the availability of reproductive services in communities where deals have been struck between Catholic and non-Catholic hospitals. Community concerns will continue to cause problems for dealmakers (Sept. 28, p. 28).
Don't be surprised to see more antitrust cases. Activists are encouraging communities to contact the Federal Trade Commission and the U.S. Justice Department about mergers they believe will restrain services.
With providers around the country struggling to survive in the insurance business, more not-for-profit systems are likely to exit that market. Risk contracting isn't turning out to be as profitable as executives expected.
For the American Hospital Association, 1999 will mean a continued struggle to overcome declining dues revenues. For the first time since 1995, AHA members will be hit with a dues increase. The 2.5% climb could bring in as much as $1.4 million for the Chicago-based trade association, which collected $56.3 million in dues revenues in 1997. Dues projections for 1998 were down about 5%, to $53.6 million (Dec. 14, p. 20).