Merger and acquisition activity is picking up steam this year after a decline in deal volume during the pandemic, with some large health systems reorganizing their portfolios and offloading hospitals in various markets.
Four health systems that have sold or plan to sell multiple hospitals this year:
Editor's note: This is not an exhaustive list.
1. Tenet Healthcare
- Dallas-based Tenet, a for-profit system, sold three South Carolina hospitals to Winston-Salem, N.C.-based Novant Health for $2.4 billion, effective Feb. 1. The hospitals include East Cooper Medical Center in Mount Pleasant, Hilton Head Hospital and Coastal Carolina Hospital in Hardeeville.
- In March, Tenet completed the $975 million sale of four Southern California hospitals to Orange, Calif.-based UCI Health.
- Tenet also sold California hospitals to Roseville, Calif.-based Adventist Health in March. Adventist bought the hospital for about $550 million.
- Tenet has agreed to sell its 70% majority ownership interest in Birmingham, Ala.-based Brookwood Baptist Health to Orlando (Fla.) Health. The proposed deal is valued at approximately $910 million in cash. Conifer Health Solutions, Tenet's revenue cycle management arm, will also enter into a 10-year contract to provide services for the Alabama hospitals.
2. Ascension
- St. Louis- based Ascension sold Our Lady of Lourdes Memorial Hospital System in Binghamton, N.Y., to Sayre, Pa.-based the Guthrie Clinic in February. The transaction included Lourdes Hospital in Binghamton, N.Y., its locations and related physician practices. Financial terms of the deal were not disclosed.
- Midland-based MyMichigan Health on Aug. 1 acquired three Ascension Michigan hospitals in Standish, Tawas and Saginaw as well as their related Ascension Medical Group care sites and physician practices. Financial terms of the transaction were not disclosed.
- Ascension plans to sell nine Illinois hospitals to Ontario, Calif.-based Prime Healthcare for an undisclosed price. The transaction, which is expected to close in the first quarter of 2025, also includes the sale of four post-acute and older adult living facilities operated by Ascension Living.
- The University of Alabama System plans to acquire Birmingham-based Ascension St. Vincent's Health System for $450 million. UAB Health and Ascension expect the deal to be completed in the fall, pending regulatory approvals.
- St. Louis-based Mercy aims to purchase Ascension Via Christi Hospital in Pittsburg, Kan., for an undisclosed amount. The proposed transaction includes the hospital, its locations and related physician practices, but excludes Ascension Living Via Christi Village facilities and operations. The deal is subject to regulatory approvals.
3. Community Health Systems
- Franklin, Tenn.-based, CHS has sold 29 hospitals since 2020, including the Aug. 1, 2024, sale of Tennova Healthcare-Cleveland (Tenn.) to Vitruvian Health in Dalton, Ga. CHS sold the 351-bed hospital for $160 million, but may receive an additional cash payment based on potential changes to certain supplemental reimbursement programs.
- CHS has signed a definitive agreement to sell its three Pennsylvania hospitals to nonprofit WoodBridge Healthcare. The proposed $120 million deal — which would see CHS exit Pennsylvania — is expected to close in the fourth quarter, pending regulatory approvals and closing conditions.
- The 71-hospital, for-profit system plans to take in $1 billion from hospital sales this year despite Novant calling off its plan to acquire two of its North Carolina hospitals for $320 million in June.
4. Prospect Medical Holdings
- Los Angeles-based Prospect, a for-profit hospital operator, plans to sell nine of its 16 hospitals in three different states. Prospect and CHA Partners signed a letter of intent in August for CHA to acquire Upland, Pa.-based Crozer Health. The proposed deal would involve transitioning Crozer's four hospitals back to nonprofit status. CHA, which owns five hospitals in New Jersey, is working to reach a definitive agreement for the acquisition of Crozer.
- In June, Prospect, received conditional approval from the Rhode Island Attorney General to sell its two safety net hospitals in Providence to the Centurion Foundation, an Atlanta-based nonprofit. The hospitals are owned and operated by Prospect's CharterCare Health Partners.
- Yale New Haven (Conn.) Health had planned to acquire three Connecticut hospitals from Prospect, but sued to get out of the deal in May. Yale New Haven alleges that Prospect engaged in irresponsible financial practices and breached its contract by not paying rent and taxes on time, letting the three hospitals deteriorate. Prospect filed a countersuit alleging that Yale New Haven breached its acquisition agreement by failing to deliver the agreed-upon purchase price and by not making reasonable best efforts to complete the transaction.