Key Insights

Updated: January 18, 2022

  • There were 17 hospital deals announced during the fourth quarter, an increase from the previous quarters. For the year as a whole though, the 53 deals completed represented the lowest level of activity in more than 13 years. Transaction volume is expected to rebound in 2023 as pressure mounts on hospital operating margins, investment portfolios decline and the threat of defaults looms.
  • Average transaction size measured by revenue ballooned to more than $1 billion, nearly doubling the previous annual record. That average deal was heavily weighted by Advocate Aurora Health and Atrium Health, which completed their merger in December, forming a $27 billion system with 67 hospitals across six states. The combined system, Advocate Health, is based in Charlotte, North Carolina.
  • Lansing, Michigan-based University of Michigan Health said in December that it would acquire the six-hospital Sparrow Health System, which is also based in Lansing. If the deal goes through as expected in the first half of 2023, pending customary regulatory approvals, University of Michigan would expand to a $7 billion, 11-hospital system.
  • Duluth, Minnesota-based Essentia Health and Marshfield (Wisconsin) Clinic Health System signed a memorandum of understanding to merge in October. The combined system would have 25 hospitals across Minnesota, Wisconsin, Michigan and North Dakota.


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