Objective Financial Advice

Juniper believes a critical need exists for nonprofit institutions to have an advisory firm which is both qualified to provide experienced and dedicated strategic advice and free of potential conflicts of interest created within larger, multi-product financial service companies.

We view every engagement as a unique set of circumstances and challenges. And because the Juniper team members have worked together for nearly three decades, we have an open, collegial culture that brings together our deep experience for the benefit of each client. There are no competing silos or profit centers at Juniper. We are one team, solely committed to achieving the best outcome for our clients.

Experience & Qualifications

Juniper is an independent advisory firm dedicated to providing nonprofit institutions, particularly hospitals and health systems, with expert merger and acquisition (M&A) and other strategic affiliation advice. We are the only experienced firm focused exclusively on this industry on a full-time, dedicated basis. Our business is guiding hospital system Boards of Directors and management teams through complicated and economically important independence assessments, affiliations, partnerships, and business combinations.

We understand the complex and continually-evolving challenges faced by nonprofits in the healthcare and higher education fields. To continue to fulfill their mission and innovate while pursuing scale and long-term vitality, nonprofit institutions need sound financial counsel. Juniper has the most experienced team of advisors in the field committed to providing our clients with the best possible outcomes.

Developing successful partnership structures for nonprofit institutions is our singular focus. This is all we do and we do it well. Over the past 25+ years, our team has advised on many of the largest and most noteworthy business combinations and partnerships in the industry. We have performed 225 advisory assignments and completed more than 125 transactions in 42 states.

Our clients can tell our story far better than we can. They have experienced Juniper’s service and expertise first-hand. We would be pleased to have you contact our clients for a reference. Please contact us to hear more about Juniper’s value proposition from a client’s perspective.

Featured Client Services & Transactions

Client Service Description
Advocate Healthcare – Evangelical Health System The largest nonprofit health system in Illinois. Juniper assisted Evangelical Health Systems in their assessment and negotiation with Lutheran General Health System in their merger to form Advocate.
Advocate Healthcare – Lutheran Health System Advocate is the leading nonprofit hospital system in Illinois. We advised Evangelical Health Systems in their assessment and negotiation with Lutheran Health System in a consolidation transaction to form a new company, Advocate.
Ascension Heath Ascension is the largest nonprofit system in the U.S. Juniper has advised Ascension on 11 separate divestitures over the past 20 years.
University  Of Cincinnati Juniper advised on the largest dissolution of a joint operating agreement (Health Alliance) and assisted the University in its exit and subsequent acquisition of Westchester Hospital.
Brackenridge Hospital Juniper advised Ascension Health on its long-term lease of the hospital, which, as the City of Austin’s safety-net hospital, was undergoing severe financial strain. Now known as University Hospital, it is part of the Seton Family of Hospitals and has won numerous quality awards.
Health Midwest We advised this Kansas City, MO based organization on the sale of its fourteen-hospital system in 2004. It was the largest “conversion” in history and a major test of the oversight of state attorneys general. The system’s annual revenues were $1.06 billion.
Hillcrest Healthcare System Located in Tulsa, OK, this was one of the most complicated hospital system divestitures in recent years, and a major precedent related to the retirement of non-callable municipal bonds under troubled circumstances. We provided an options assessment and advised on the sale in 2005. Hillcrest had annual revenues of $350 million.
Marquette General Health System Juniper advised the board of directors in Marquette, MI on this innovative joint venture arrangement between Duke University and LifePoint Hospitals. This was the largest rural transaction of the decade and the first ever robust, market clearing process in Michigan.
Methodist Health Services Corporation Juniper advised the Board of this two hospital system in Peoria, IL on their cross-state-border merger with Iowa Health System.
Providence Health & Services Juniper advised PHS on the divestiture of its Central Washington operations (Seattle-based). This was the first “conversion” sale to an investor-owned company under Washington State’s new statute and was completed in less than six months.
Saint Claire’s Health System This Denville, NJ-based system was advised by Juniper on its three-hospital system & membership substitution transaction with Catholic Health Initiatives.
Wyoming Valley Health Care System Juniper advised on WVHCS’s sale to Community Health Systems, which closed in April, 2009 and was the first sizable hospital transaction completed after the financial crisis of 2008. The advisory relationship was based in Wilkes-Barre, PA, and WVHCS had annual revenues of $220 million.

For a full list of transactions and related case studies, visit our Transactions page.


Health System Advisory

Juniper’s team is nationally recognized as a leader in strategic health system advisory services.


Research and Support

Juniper’s long-standing commitment to evidence-based decisions drives our ability to offer the right advice for your organization.


Unbiased Leadership

The Juniper team is ready to handle any strategic partnership that your organization is considering.