Publications

Our Take: Considering Quality in a Business Combination 

Of the umpteen elements hospital leaders evaluate when considering the viability of a potential partner, quality is generally at the top of the list.

A larger partner can bring the scale, resources and expertise many smaller hospitals and systems seek to improve care quality for their community.…

August 29th, 2018| News & Events, Publications|

In the News: Temple hires Juniper as it explores possible sale

Philadelphia Business Journal

Temple University announced Monday it has retained the services of Juniper Advisory to pursue strategic options for Temple University Health System, which include the possible sale of Fox Chase Cancer Center, neighboring Jeanes Hospital or both.

The move comes about a month-and-a-half after Temple’s Board of Trustees announced it had authorized a series of steps aimed at strengthening the health system’s finances and “preserve its ability to serve its mission.” One of those steps was authorizing the engagement of a financial advisor.…

Our Take: A Case Study of Rural Success

Rural providers have been somewhat insulated by the transformation in the health care market over the past decade. Caught between understanding and implementing population health strategies, they are still heavily reliant on fee-for-service reimbursement models versus value-based care.  Rural hospitals are fighting for their margins, with few resources available to pilot innovative care strategies or make capital upgrades.…

July 25th, 2018| Publications|

Valuing the Troubled Hospital

Financial difficulties are commonly the catalyst for hospitals to begin exploring partnership options. As Rex Burgdorfer, Juniper Advisory Vice President, outlines in his latest article “Valuing the Troubled Hospital”, court-led restructuring is an option often considered by those with liquidity constraints and significant financial liabilities.…

June 22nd, 2018| Publications|

Multi-State Health Systems: On Their Way at Last

As mid-size health systems seek growth and meaningful scale, the most effective way to achieve this will be system combinations, and these will include those across state lines. The recently completed combination of Advocate Health Care of Chicago and Aurora Health Care of Milwaukee is an example of this kind of transaction cross-border combination.…

June 13th, 2018| Publications|

Acquisition Currencies in Non-Profit Hospital M&A

We note how health systems will likely “pay” for their newfound acquisition appetite, and review techniques that are being utilized. The potential for an increased pace of change is focusing greater attention on the terms, conditions, and value exchanged (financial and otherwise) in business combinations.…

April 24th, 2018| M & A, Publications|

Public Hospitals and Partnerships

Hospitals and health systems face an array of compounding pressures. Chief among these is a shift to population health and value-based care models that require health systems to not only continue to make investments in information technology, administration and care, but also take on additional financial risk.…

February 12th, 2018| M & A|

A Year of Change for Community Hospitals

As 2017 comes to an end, we thought it would be helpful to The Governance Institute membership to provide some observations regarding the state of health system merger and acquisition (M&A) activity, and specifically its impact on independent non-profit hospitals.

First, the industry remains among the most fragmented in the U.S.

December 15th, 2017| M & A|

Is Healthcare a Charity, Social Service, or Business? Community Hospital Board Members Contemplate Their Role

Board members of independent hospital companies are in the cross-hairs. They govern during a time of intense industry and societal change. Situated at the center of a national struggle, they contend with front-page news, and tweets, daily. Directors are challenged not only by these major economic and political issues but also by the tremendous volume of day-to-day operational detail involved in running a complex enterprise.…

September 15th, 2017| Role of the Board|

Membership Substitution Transactions: Why Are They So Misunderstood?

Membership substitution transactions are the most common form of business combination transaction in the nonprofit hospital industry. They are also widely misunderstood and the source of many mistakes. Many large 501(c)(3)s have become more acquisitive as a result of economic pressures of the ACA.…

February 14th, 2017| Transaction Structures|