Publications

Multi-State Health Systems: On Their Way at Last

Publications

June 13, 2018

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...

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Acquisition Currencies in Non-Profit Hospital M&A

Publications

April 24, 2018

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...

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Public Hospitals and Partnerships

Publications

February 12, 2018

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...

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A Year of Change for Community Hospitals

Publications

December 15, 2017

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...

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Is Healthcare a Charity, Social Service, or Business?

Publications

September 15, 2017

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...

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Membership Substitution Transactions: Why Are They So Misunderstood?

Publications

February 14, 2017

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...

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Hospital Industry Structure: Considering the Impact of the Affordable Care Act

Publications

February 1, 2017

In its 2010 Governance Institute white paper, Juniper Advisory described the ownership structure of the hospital industry in anticipation of the impact of healthcare reform and the Affordable Care Act...

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Change, the One Constant

Publications

December 20, 2016

It is difficult to not get swept up into the tidal wave of speculative news about the changes that health systems may confront as we move into 2017. Every day...

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Partnership Road Map: Navigating Health System Integration

Publications

September 12, 2016

The decision to align with another health care organization is among the most important, if not the most important, undertakings for a hospital board. Selecting the right partner, strategy, timing...

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Do Hospital Affiliations Risk Becoming the Next Brexit?

Publications

July 5, 2016

The European Union is an affiliation. Unlike a federal government, the United States for example, where members combine into a single sovereign nation, each member state of the EU remains...

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Defending the Deal: AG Review Process in Hospital Conversions

Publications

April 15, 2016

As the delivery of health care continues to evolve and hospitals bear additional pressures to adapt to new payment models, more nonprofit hospitals are partnering with for-profit providers, through a...

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What Hospital Leaders Can Learn From ‘Downton Abbey’

Publications

March 17, 2016

In its final season, “Downton Abbey” captured audiences by exploring a healthcare phenomenon set in rural England 100 years ago — and one still playing out across America today. The...

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