Hospital merger and acquisition activity reached a 10-year low as deal volume continued to slump in the third quarter, according to a new report.
The 12 announced acute-care hospital transactions in the third quarter marked the fifth consecutive quarterly decline in volume, amounting to the lowest trailing four-quarter tally since 2010, according to Ponder & Co. While health systems are still actively exploring potential deals, it wasn't surprising that the COVID-19 pandemic slowed or derailed some transactions, said Eb LeMaster, a managing director at the healthcare advisory firm.
"Activity will tick up, but I am not sure that there will be a massive wave of deals on the other end of this that some are predicting," he said. "Sellers are trying to figure out where they stand; buyers are being more selective."
In addition to the financial upheaval, video conferencing is another limitation, LeMaster said. Zoom only goes so far when relatively unfamiliar parties come to the table, he said.
Many of the organizations formalizing deals were large not-for-profit health systems. Aside from the Catholic health system acquirers with more than $10 billion in revenue, the others that announced acquisitions in the third quarter were academic medical centers or organizations with significant academic affiliations, according to the report. Most of the recent transactions were between in-state or market adjacent parties.
While there have been some divestitures, the for-profit sector has been uncharacteristically silent, LeMaster said. There have been no announced acquisitions during the first nine months of 2020 by the publicly traded hospital companies, many of which are still digesting large mergers or are conserving capital, he said.
"None by that group year to date is saying something," LeMaster said.
Hospital M&A experts suspect activity to pick up in the second half of next year, although to varying degrees. Pent-up demand, increased cash flow from COVID-19 relief funding, expense management and patient volumes will all come into play.
Government funding has boosted liquidity for large systems, which has created an environment rich for consolidation, Ken Marlow, a partner and healthcare industry chair at Waller Lansden Dortch & Davis, told Modern Healthcare last week after M&A talks between Advocate Aurora Health and Beaumont Health fell apart.
"(Large systems) see this as an opportunity to deploy those resources," he said.