This story was updated Aug. 25, 2017.
It should come as no surprise that Ascension is stepping up to acquire Presence Health or that Dignity Health is trying to partner with struggling Catholic Health Initiatives, said former Ascension hospital official Dr. Mike Schatzlein.
Catholic health systems look after each other to try to maintain the operating values and emphasis on the underprivileged that reflect their shared mission, said Schatzlein, who is now of counsel to consultancy Jarrard Phillips Cate & Hancock in Brentwood, Tenn.
"There's a general belief in preserving Catholic healthcare," said Schatzlein, who identified himself as Lutheran. "There's no rule. No sense of collusion. Not even an unwritten rule. It's a common culture and mission to the poor."
Ascension's proposed pickup of Presence Health in Chicago comes as a two-year turnaround effort at Presence has experienced fits and starts. The system narrowed operating losses to $40 million in 2016 from an operating loss of $186 million in the prior year. But that performance was still short of system targets, Presence CEO Mike Englehart recently said.
San Francisco-based Dignity is in affiliation talks with money-losing CHI of Englewood, Colo.
Dignity changed its charter and name from Catholic Healthcare West in 2012 so that the parent organization of 39 hospitals is no longer Catholic-sponsored.
But most of the Dignity hospitals still have Catholic sponsorship and the parent's mission statement commits to "furthering the healing ministry of Jesus."
If the Dignity-CHI talks, which began last year, lead to a merger, it would create a system even larger than Ascension with 142 hospitals combined and annual revenue of more than $26 billion.
CHI is struggling. It posted an operating loss of $483 million in fiscal 2016 and has been restructuring through cost-cutting, exiting its health plan and selling money-losing hospitals in Louisville, Ky.