A new report shows that annual hospital merger transaction activity has fallen to its lowest level in more than a decade.

According to data from a healthcare consulting company, the number of transactions announced in 2021 fell to 71, which is the lowest level since 2009 and the fourth consecutive year of decline Thinking company. The destruction of the COVID-19 pandemic Suspended many planned transactionsExperts say that many health systems have been able to maintain stability due to delays in relief funds and reimbursement reductions.

Jake Aygun, Ponder’s head of mergers and acquisitions, said: “When acquiring assets that may face challenges, buyers will be more critical and wise, questioning whether they can play a role in this environment.”

Ponder managing director Eb LeMaster said that although hospital executives are still exploring potential deals, the volume of mergers and acquisitions may not rebound until 2023. Strengthen the clinic network He said this is a higher priority.

“We will not go back to the Wild West era of the mid-90s, where we saw 150 transactions every year. Many health systems do not rely on hospital acquisitions for future growth-so many centers around the outpatient department,” LeMaster said. And pointed out that Tenet Healthcare Acquisition Outpatient surgery center. “Regulators are paying close attention to it.”

For example, LifePoint Health and Kindred Health closed their trade A new company was established last month, consisting of 61 long-term acute care hospitals in Kindred and 18 community hospitals in LifePoint.

Although President Joe Biden and the federal antitrust agency have promised Blow Regarding anti-competitive integration, including the practice of hospitals acquiring doctors, Case law and regulatory guidelines have not kept up Industry regulators said that with the trend of vertical integration.

“The foundation of the health system itself is problematic,” said Nathan Ray, partner at West Monroe, who leads its healthcare M&A department, adding that the health system will continue to expand beyond the inpatient department. “The health system is trying to understand whether they should be the nexus of intensive care centers, maternity wards, multi-specialty care, or just the largest emergency facility in a region. These issues, especially telemedicine and the pandemic, have made face-to-face aspects The intense care has changed the way these organizations need to think strategically.”

As the number of hospital transactions continues to decline, the value of transactions in 2021 will be boosted by several large transactions.

Intermountain Healthcare and SCL Health Propose a deal After the Intermountain and Sanford Health deal broke down, the company formed a $11 billion company with 33 hospitals.Beaumont Health signed a Final agreement After abandoning the merger with Summa Health and Advocate Aurora Health, cooperated with Spectrum Health. Lifespan Health System, Care New England and Brown University Join hands Form a regional academic system.

At the same time, for-profit chain hospitals HCA Healthcare, purpose and Community health system Some inpatient facilities were divested in smaller markets. HCA announced on Tuesday that it has acquired MD Now Urgent Care, which has 59 urgent care centers and will strengthen its growing network in Florida.

Aygun said: “Four or five years ago, with wave after wave of major mergers, people expected a rationalization of the portfolio.” “We will see this move forward, but it will take a while.”

have Fewer independent hospitals And the smaller system limits the options of the acquirer. Wrong integration plan, Diluted returns and Increasingly stringent regulatory review Experts say that a highly concentrated market can also explain the decline in trading volume.

Jordan Shields, a partner at Juniper Advisory, said that even so, activity may start to rebound in the second half of 2022 and 2023.

He said: “Most of the announcements in the fourth quarter came from troubled sellers who had no choice but to go public during the peak of the pandemic.” I came to the other side of Omicron at the beginning of the quarter and asked myself if I can better serve the community through a larger platform. We will see more announcements in the second half of 2022.”