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  4. > Analysis of Mergers and Acquisitions Trends in the United States Healthcare Provider Industry

Coalesce to Survive is the New Life Line

The challenges posed by reducing margins and increasing compliance costs and regulatory thrusts due to the implementation of the Affordable Care Act forces healthcare provider industry participants to restructure and streamline strategies to eliminate diminishing profitability. This study analyses various M&A industry deals. The deals are analyzed based on the number and average deal value, and trends are observed based on the target and buyer type. The study delves into the nature of sellers and considers various deal multiples like enterprise value, percent sought, and integration type. Research utilizes business/financial databases, company annual reports, and published news. The study period runs January 1, 2007 to November 14, 2013.

Key Terms Used in the Study

Transaction:
Mergers and Acquisitions (M&A): Mergers and acquisitions is an aspect of corporate strategy, corporate finance, and management by which corporations legally unify the ownership of assets that were formerly subject to separate controls. The term deal in the study refers to M&A transactions. Industry Healthcare Provider

Industry:
This industry includes healthcare facilities, including hospitals, nursing homes, rehabilitation centers, health maintenance organizations (HMOs), and other managed plans.

Sectors:
•Surgical and Emergency Centers: Establishments that offer healthcare services to a person who has an injury or disease that occurs suddenly and requires immediate treatment.
•Psychiatric Hospital Services: Establishments known and licensed as psychiatric hospitals primarily engaged in providing diagnostics, medical treatment, and monitoring services for inpatients who suffer from mental illness.
•Specialty Hospitals: Establishments known and licensed as specialty hospitals primarily engaged in providing diagnostic and medical treatment to inpatients with a specific type of disease or medical condition.
•Hospice Services and Centers: Establishments that offer medical and emotional care for the terminally ill
oHospice care, typically offered in the last 6 months of life, emphasizes comfort measures and counselling to provide social, spiritual, and physical support to the dying patient and his or her family.
•Intermediate Care Facilities: Establishments that are primarily engaged in providing inpatient nursing and rehabilitative services, but not on a continuous basis.
•Dialysis Centers: Establishments with medical staff primarily engaged in providing outpatient kidney or renal dialysis services.
•Medical Practice Organizations: Establishments that offer healthcare services for a set fee by using a network of physicians and other providers who have agreed to the established rates.

Executive Summary

Rationale for M&A
The challenges posed by reducing margins and increasing compliance costs and regulatory thrusts due to the expected full-fledged implementation of the Affordable Care Act is forcing healthcare provider industry participants to restructure and streamline strategies to eliminate diminishing profitability. M&A have become the key strategy used to reverse the trend of declining profits by increasing the economies of scale and helping the entry of capital to manage the costs incurred for compliance to regulations.

Key Trends
•The deal activity in the healthcare provider industry has shown a tremendous increase during the study period.
•The increase in the deal volume was not accompanied by a relative increase in deal value, indicating the increase of deals with a low average deal value.
•The marginally increasing valuation multiples for the healthcare provider industry reveal that the sector is regaining investor confidence.
•The surgical and emergency centers and post–acute care sectors have been the most preferred segments, in terms of deal activity from the data analyzed in the study period.

Objectives of the Study

To analyze the M&A trends in the US healthcare provider industry
To identify the key M&A trends in the industry based on deals across sectors and the nature of buyers
To conduct a financial analysis of the deals with respect to valuation multiples
To identify, compare, and assess sectors that are current and potential hubs for M&A activity
To arrive at strategic conclusions on the basis of the key trends observed

Research Objective

Study Period
January 1, 2007 to November 14, 2013

Geographic Scope
The United States

Deals Analyzed
2010 deals

Analysis Includes
•Across sectors
•Valuation multiples
•Stock price variations
•Percent of stake acquired
•Type of buyers
•Type of sellers

Who Will Benefit?
•Healthcare providers
•Private equity
•Venture capital investors
•Fund managers
•Retail investors
•Sovereign wealth funds
•Hedge funds
•Insurance funds and other members in the investing community

Sources
•Frost & Sullivan in-house research expertise
•Established business and financial databases, such as Capital IQ
•Company annual reports
•Published news
•Press releases

Note: Unless otherwise mentioned, the year 2013 includes deals from January 1, 2013 to November 14, 2013

Research Methodology

Primary Research
CEOs/CFOs
General partners
Limited partners
Board members
Research heads
Strategic decision makers
Financial advisors
Other investors

Secondary Research
Financial journals
Annual reports
Market research services
Industry Web sites
Industry-related databases
Thought-leader briefings

Table Of Contents

Analysis of Mergers and Acquisitions Trends in the United States Healthcare Provider Industry
Table of Contents

1. Executive Summary
2. Introduction
3. The Key Rationale for MandA
4. Key MandA Statistics
5. Type of Integration
6. Type of Target
7. Key MandA Metrics
8. Transaction Details
9. Conclusion
10. The Frost and Sullivan Story

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