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12 must-reads on hospital M&A

Hospitals and health systems recognize the value of mergers, acquisitions and other types of partnerships in the quest to efficiently provide more coordinated care. However, the first few steps of any transaction can be challenging.

Here are 12 articles and commentary pieces on healthcare transactions, brought to you by Becker's Hospital Review.

1. Third time's not a charm: Why the Lahey-Beth Israel merger has failed three times
Burlington, Mass.-based Lahey Health and Boston-based Beth Israel Deaconess have attempted to join forces numerous times, but to no avail. The health systems' attempts at merging show more than a lack of a solid relationship — they provide a deeper look at the background of healthcare in Massachusetts and the power of market share.

2. Calling it off: Why some hospital mergers fail and others don't
Each week, more hospitals announce plans to merge, combine or express interest in some type of partnership arrangement. While many of these deals are executed successfully, another outcome is also possible — that of the transaction unraveling. Various experts spoke to Becker's Hospital Review to discuss potential reasons hospital transactions can go awry, best practices to avoid problems and possible serious negative repercussions hospitals and leaders face if a deal does fall through. 

3. 4 common mistakes in determining fair market value for physician compensation
Industry regulations require healthcare organizations to pay fair market value compensation to physicians for their services. Due to the lack of a published set of standards to concretely establish FMV for physician compensation, misconceptions of what determines and substantiates FMV are common in the market. 

4. Co-management agreements 101: Basic principles to know
Mergers, acquisitions, partnerships, affiliations, co-management agreements, joint ventures, service line agreements, leasing arrangements and strategic partnerships. Sometimes it seems as though the world of healthcare has turned into a Baskin Robbins, with 31 flavors of hospital transactions out in various shapes, sizes and scopes. To get back to basics, this article is one of a three-part series dedicated to one of those models. There are no dumb questions here — this is co-management agreements 101.

5. 20 best practices for healthcare M&A
The current healthcare environment is creating one of the most active hospital and health system consolidation markets in decades. This consolidation is partially driven by provider responses to the challenges and opportunities created by national and state healthcare reform. In addition to complex business considerations, hospital and health system transactions implicate a vast body of state and federal laws, which complicate a transaction process, leaving many opportunities for missteps or complications. Becker's Hospital Review outlined the 20 best practices to help hospital and health system executives navigate the transaction process from beginning to end. 

6. 10 necessary points for a due diligence checklist
Due diligence is a necessary step in a transaction. Whether it is a clinical affiliation or a full sale, due diligence is conducted so both parties fully understand the other. Whether the transaction involves a hospital acquisition of a practice or another hospital, the same general principles apply in effectively and efficiently conducting due diligence. The first step should be to develop a robust due diligence checklist. 

7. The rise of 'super regional systems' and what it means for healthcare
Mergers, acquisitions and other types of partnerships are critical as hospitals focus on providing coordinated, cost-effective care. Through consolidation, hospitals become more efficient and, many times, improve care quality. However, consolidation also increases leverage and causes revenue to rise, leading to the creation of "super regional systems."

8. 5 things to know about the merger of health systems and insurance providers
Traditionally, healthcare delivery and health insurance existed as two separate types of business. But there is a trend in the healthcare industry: hospitals and health systems buying insurance companies or creating their own insurance arms.

9. 10 lessons from leaders who have merged or acquired hospitals
There is no instruction manual when it comes to hospital mergers, acquisitions and affiliations. Sometimes it is simply most helpful to hear from leaders who have been through these transactions and what they've learned. Becker's Hospital Review spoke with three hospital and healthcare executives with a lot to say about their experiences in acquiring, merging or affiliating with other providers. 

10. In the Midwest, health systems go big or go home: The new reality of system dominance
Hospital consolidation is occurring in markets across the nation — particularly those in the Midwest.

11. Good, bad or too tough to say? What 4 health system CEOs think of hospital consolidation
There is a great deal of consolidation occurring in the healthcare industry today. Whether that is good or bad news to health system CEOs depends on their organization's market and M&A track record. Former publisher of Modern Healthcare, Chuck Lauer, asked a panel of speakers to give their thoughts on provider consolidation.

12. Is bigger always better? Exploring the risks of health system mega-mergers
One idea that has gained a significant amount of traction in the past few years is that of "Big Medicine." Brigham and Women's surgeon and writer Atul Gawande, MD, propelled the phrase in his New Yorker op-ed in 2013, in which he drew analogies between American healthcare and The Cheesecake Factory restaurant chain. 

More articles about transactions and valuations:
Rise of the megamerger: 3 ways M&A affected the healthcare industry in 2015
Injunction resolved in Hawaii hospital transition
Answer Health in talks to merge with two local physician groups

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