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.
Five 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 sold 2 more California hospitals to Roseville, Calif.-based Adventist Health in March. Adventist bought the hospitals for about $550 million.
- In October, Tenet sold its 70% majority ownership interest in Birmingham, Ala.-based Brookwood Baptist Health, a five-hospital system, to Orlando (Fla.) Health for about $910 million in cash.
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.
- St. Louis-based Mercy on Sept. 1 acquired Ascension Via Christi Hospital in Pittsburg, Kan., for an undisclosed amount. The transaction included the hospital, its locations and related physician practices, but excluded Ascension Living Via Christi Village facilities and operations.
- On Sept. 30, Ascension Michigan and Detroit-based Henry Ford Health launched a joint venture in which Henry Ford folded Ascension's care sites in the southeastern region of the state under its brand. Ten Ascension acute care hospitals and their related care sites will be renamed and rebranded to Henry Ford Health.
- Ascension on Nov. 1 sold Birmingham-based Ascension St. Vincent's Health System, a five-hospital system, to the University of Alabama System for $450 million.
- The health system plans to sell nine Illinois hospitals to Ontario, Calif.-based Prime Healthcare for about $375 million. 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.
3. Community Health Systems
- Franklin, Tenn.-based, CHS 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 and may receive an additional cash payment based on potential changes to certain supplemental reimbursement programs.
- CHS signed a definitive agreement in August 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.
- In October, CHS sold Davis Regional Psychiatric Hospital and Davis Regional Medical Center in Statesville, N.C., to Iredell Health System.
- The for-profit system plans to sell Merit Health Biloxi (Miss.), a 153-bed acute care hospital, to Gulfport, Miss.-based Memorial Health System. Financial terms of the deal — which is expected to close in the first quarter — have not been disclosed.
- The for-profit system plans to take in $1 billion from planned hospital sales to help reduce its long-term debt, which stands at about $11.5 billion.
4. Prospect Medical Holdings
- Los Angeles-based Prospect, a for-profit hospital operator, plans to sell 10 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, a four-hospital system. CHA, which owns five hospitals in New Jersey, is working to reach a definitive agreement for the acquisition of Crozer, despite reports that it backed out of the deal, a spokesperson for Prospect told Becker's.
- 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. The transactions is still waiting to be completed.
- 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.
- In November, Prospect signed a dfinitive agreement with Alhambra, Calif.-based Astrana Health to sell the company multiple assets for $745 million. The proposed transaction includes Tustin, Calif.-based Foothill Regional Medical Center as well as Prospect Health Plan, Prospect Medical Groups, Prospect Medical Systems and RightRx.
5. Steward Health Care
- Dallas-based Steward, which operated 31 hospitals in eight states at the start of this year, filed for bankruptcy in May. The health system closed or sold its hospitals as part of its restructuring efforts.
- Several health systems stepped in to acquire Steward's hospitals, including Scottsdale, Ariz.-based HonorHealth, Orlando (Fla.) Health, Lawrence (Mass.) General Hospital, Glendale, Calif.-based American Healthcare Systems, Irving, Texas-based Christus Health, Providence, R.I.-based Lifespan, Boston Medical Center, Brentwood, Tenn.-based Quorum Health and Flint, Mich.-based Insight Health Systems.