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# Juniper Advisory

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- [Knox Community Hospital Signs Letter of Intent to Join Kettering Health](https://juniperadvisory.com/knox-community-hospital-signs-letter-of-intent-to-join-kettering-health/) - Transaction Announcement Knox Community Hospital has signed a non-binding Letter of Intent (LOI) to join Kettering Health, a nonprofit health system headquartered in Ohio. The proposed partnership follows an extensive strategic evaluation led by the Knox Community Hospital Board of Trustees and leadership team to strengthen the hospital's long-term sustainability while preserving and enhancing local
- [Sharp HealthCare and Tri-City Healthcare District Complete Strategic Partnership](https://juniperadvisory.com/sharp-healthcare-and-tri-city-healthcare-district-complete-strategic-partnership/) - Transaction Announcement With an overwhelming 92% voter approval, Sharp HealthCare (Sharp) and Tri-City Healthcare District (Tri-City) have finalized their strategic partnership, with Sharp assuming operational responsibility for Tri-City Medical Center under a 30-year lease agreement. Effective July 1, the hospital will operate as Sharp Tri-City Medical Center, marking a significant step toward strengthening and expanding healthcare services for North County
- [Erlanger Health System and Prisma Health Sign Letter of Intent for Strategic Partnership](https://juniperadvisory.com/erlanger-health-system-and-prisma-health-sign-letter-of-intent-for-strategic-partnership/) - Transaction Announcement Erlanger Health System, a seven-hospital nonprofit health system based in Chattanooga, Tennessee, has signed a non-binding Letter of Intent (LOI) to pursue a strategic partnership with Prisma Health, one of the Southeast's leading nonprofit health systems. The proposed partnership is intended to build on Erlanger's longstanding commitment to high-quality, compassionate care while supporting
- [Freeman Health System Completes Expansion into Northwest Arkansas](https://juniperadvisory.com/freeman-health-system-completes-expansion-into-northwest-arkansas/) - Transaction Announcement Freeman Health System has completed its acquisition of Northwest Health, a four-hospital subsidiary of Community Health Systems, Inc. (NYSE: CYH), including facilities in Bentonville, Springdale, Siloam Springs, and Johnson, Arkansas. The transaction represents a significant regional expansion for Freeman and reflects the continued trend of nonprofit health systems growing through acquisitions of community hospitals from for-profit operators. With
- [Webinar Series - Medicaid Cuts Through Budget Reconciliation - Epstein Becker Green](https://juniperadvisory.com/webinar-series-medicaid-cuts-through-budget-reconciliation/) - Part 1: Pathway to Cuts Through Reconciliation Tuesday, April 15 | 1:00 p.m. ET For hospitals and other providers, anticipating the timing and form of Medicaid cuts is crucial to informing their advocacy and planning. Join Epstein Becker Green and Juniper Advisory for a deep-dive, live webinar into Congress’s pathway to adopting Medicaid cuts through
- [Running in Place: The Cycle That Keeps Health Systems from Growing](https://juniperadvisory.com/running-in-place-the-cycle-that-keeps-health-systems-from-growing/) - Adam Davis, Executive Director, Juniper Advisory Many independent nonprofit health systems and hospitals face a vicious cycle of industry challenges that prevents them from achieving their true growth potential. We call this the “Health System Capital Spending Paradox,” and its manifestation is made possible by strict rating agency criteria and lender covenants that force hospital
- [Juniper Advisory Promotes Brent McDonald, Farley Reardon, and Casey Webb to Partner](https://juniperadvisory.com/juniper-advisory-promotes-brent-mcdonald-farley-reardon-and-casey-webb-to-partner/) - We are pleased to announce the promotion of Brent McDonald, Farley Reardon, and Casey Webb as Partners at Juniper Advisory. “Juniper leads the industry in delivering thoughtful, independent advice to hospitals and health systems navigating complex strategic decisions,” said Rex Burgdorfer. “Brent, Farley, and Casey have each demonstrated a strong commitment to that mission. Their experience and
- [What happens when a sale is not an option…Affiliate.](https://juniperadvisory.com/what-happens-when-a-sale-is-not-an-optionaffiliate/) - Ken Marlow, Partner, McDermott Will & Schulte Farley Reardon, Managing Director, Juniper Advisory With growing financial uncertainty for health systems that face looming changes to supplemental programs and Medicaid eligibility, health systems are driven to pursue alignment strategies to expand referral networks and resource capabilities or accessibility. Providing more with less continues to be a
- [The Scale Imperative in Managed Care: The Compounding Disadvantage Facing Sub-Scale Hospitals](https://juniperadvisory.com/the-scale-imperative-in-managed-care-the-compounding-disadvantage-facing-sub-scale-hospitals/) - Rex Burgdorfer, Partner, Ansley Geary, Associate, Juniper Advisory The Structural Problem The financial relationship between hospitals and insurers has reached an apex of complexity. The impact is disproportionately borne by sub-scale hospital systems (say less than ~$3 billion in net operating revenue). In the current market, most hospitals budget for material losses on Medicaid patients,
- [Happily Ever After: Strategies to Create Lasting Relationships and Avoid Heartbreak in Your M&A Deals](https://juniperadvisory.com/happily-ever-after-strategies-to-create-lasting-relationships-and-avoid-heartbreak-in-your-ma-deals/) - New in Health Law Connections: The latest issue features Happily Ever After: Strategies to Create Lasting Relationships and Avoid Heartbreak in Your M&A Deals by Brent McDonald, Managing Director, Juniper Advisory and Torrey McClary, Partner, Ropes & Gray LLP. Health care organizations are continuously evolving to meet patient needs, enhance services, and strengthen their long-term
- [Samaritan Announces Affiliation with MultiCare](https://juniperadvisory.com/samaritan-announces-affiliation-with-multicare/) - Transaction Announcement Samaritan Health Services (SHS), an integrated, five-hospital nonprofit health system based in Corvallis, Oregon, generating approximately $1.7 billion in annual revenue, and MultiCare Health System, a nonprofit health system headquartered in Tacoma, Washington, have announced an affiliation to strengthen access to community-based health care across Oregon and the Pacific Northwest. Completion of the affiliation
- [Culture Change RX Podcast - Should You Really Partner? The Decision That Shapes Your Hospital’s Future](https://juniperadvisory.com/culture-change-rx-podcast-should-you-really-partner-the-decision-that-shapes-your-hospitals-future/) - Partnership conversations in healthcare often begin with financial projections and market pressures, but the partnerships that succeed are rarely decided by economics alone. In the latest episode of Culture Change RX, Sue Tetzlaff - Culture and Execution Catalyst sits down with Chris Benson, FACHE, CMPE, Managing Director, Juniper Advisory, to discuss the growing complexity of
- [2026 American Health Law Association Health Care Transactions](https://juniperadvisory.com/2026-american-health-law-association-health-care-transactions/) - We are pleased to share that Brent McDonald, Managing Director at Juniper Advisory, will be speaking at the American Health Law Association Health Care Transactions Conference. Brent will join an experienced panel for “After the Ink Dries: Balancing Autonomy and Integration in Health Care Deals”, exploring how organizations successfully navigate the critical period following transaction
- [The Changing Participants in Today’s Health System M&A Market](https://juniperadvisory.com/the-changing-participants-in-todays-health-system-ma-market/) - As financial and operational headwinds grow, a new set of participants has emerged in the health system M&A market. In the latest edition of Public Focus and Academic Health Focus by The Governance Institute, Rex Burgdorfer, Partner, Juniper Advisory, Dr. Raghu Adiga, CEO, Liberty Market, The University of Kansas Health System and Joseph Clamon, Chief
- [Crestwood Medical Center Joins Huntsville Hospital Health System](https://juniperadvisory.com/crestwood-medical-center-joins-huntsville-hospital-health-system/) - Transaction Announcement Huntsville Hospital Health System (HH Health) has completed its acquisition of Crestwood Medical Center and select related outpatient assets from an affiliate of Community Health Systems, Inc. This transaction brings Crestwood under local nonprofit ownership and represents a strategic step toward strengthening access to coordinated, community-based healthcare across North Alabama. The acquisition includes
- [Regional Medical Center Announces Agreement to Join Orlando Health](https://juniperadvisory.com/regional-medical-center-announces-agreement-to-join-orlando-health/) - Transaction Announcement RMC Health System and the City of Anniston have entered into an agreement for Regional Medical Center to join Orlando Health, a private, not-for-profit healthcare system. The agreement represents a strategic step toward strengthening the long-term future of healthcare delivery across Northeast Alabama through expanded services, new investment, and access to the operational
- [Freeman Health to acquire four CHS hospitals in northwest Arkansas](https://juniperadvisory.com/freeman-health-to-acquire-four-chs-hospitals-in-northwest-arkansas/) - Transaction Announcement Freeman Health of Joplin, MO has signed a definitive agreement to acquire Northwest Health, a four-hospital subsidiary of Community Health Systems (NYSE: CYH) in Bentonville, Johnson, Siloam Springs, and Springdale, Arkansas. The transaction represents a significant cross-border growth milestone for Freeman, the largest employer in the region. It is an example of the broader trend of for-profit
- [Huntsville Hospital Health System to Acquire Crestwood Medical Center](https://juniperadvisory.com/huntsville-hospital-health-system-to-acquire-crestwood-medical-center/) - Transaction Announcement Huntsville Hospital Health System (HH Health) and an affiliate of Community Health Systems, Inc. have entered into a definitive agreement for HH Health to acquire Crestwood Medical Center and select related outpatient assets. The transaction represents a strategic step toward strengthening locally aligned healthcare delivery across the Huntsville area. The acquisition is intended
- [Tri-City and Sharp HealthCare Announce Definitive Agreement](https://juniperadvisory.com/tri-city-and-sharp-healthcare-announce-definitive-agreement/) - Transaction Announcement Tri-City Medical Center and Sharp HealthCare have announced a definitive affiliation designed to strengthen long-term access to high-quality, community-based healthcare for North County San Diego. Under the proposed transaction, Sharp HealthCare would lease and operate Tri-City Medical Center and related facilities under a 30-year agreement, positioning the Oceanside campus to become North County’s
- [Healthcare M&A Tilts to Buyers as Independent Systems Lose Leverage](https://juniperadvisory.com/healthcare-ma-tilts-to-buyers-as-independent-systems-lose-leverage/) - Rising costs and reimbursement pressures are accelerating healthcare consolidation, especially among rural and nonurban systems. Adam Davis, Executive Director, Juniper Advisory, notes that many standalone organizations are struggling to remain independent as more financially stable and well-capitalized acquirors gain leverage in assessing growth opportunities. Transactions advised by Juniper Advisory, including Marshfield Clinic joining Sanford Health
- [Special Report: Healthcare M&A Predictions for 2026](https://juniperadvisory.com/special-report-healthcare-ma-predictions-for-2026/) - Read what trends our team believes will shape the healthcare industry and M&A market next year. They share thoughts on the macro-operating environment for hospitals and trends in acute care system consolidation. Several themes emerge. Welcome to 2026. (1) Organizations that stand still will be left behind Jordan Shields The widening gap between strong and
- [Riverview Health & Parkview Health Partner to Strengthen Care in Indiana](https://juniperadvisory.com/riverview-health-parkview-health-partner-to-strengthen-care-in-indiana/) - Transaction Announcement Riverview Health and Parkview Health have executed a management services agreement under which Parkview Health will provide operational and clinical support to Riverview Health. The agreement included a shared-risk structure and incorporated performance-based incentives tied to operational and clinical results while preserving county ownership. The partnership is designed to enhance services, drive growth,
- [Firelands Health and The Bellevue Hospital: A New Chapter for Rural Care](https://juniperadvisory.com/firelands-health-and-the-bellevue-hospital-a-new-chapter-for-rural-care/) - Transaction Announcement The Bellevue Hospital, a vital rural healthcare provider in northern Ohio, has successfully completed a court-supervised Chapter 11 reorganization that resolved complex governance and ownership challenges while preserving local healthcare access, making creditors whole and securing a significant capital commitment. Through a competitive auction overseen by the U.S. Bankruptcy Court for the Northern District
- [What Will a Trump Presidency Mean for U.S. Healthcare?](https://juniperadvisory.com/what-will-a-trump-presidency-mean-for-u-s-healthcare/) - By Farley Reardon, Managing Director, Joseph Cerisano, Analyst, and Alexander Norton, Analyst, Juniper Advisory As President-elect Donald Trump prepares to assume office for a second term, again with a Republican majority in both the House and the Senate, healthcare is likely to be an area of focus for policy initiatives, including a focus on spending
- [Sanford Health and the Marshfield Clinic Form the Premier Rural Health System](https://juniperadvisory.com/sanford-health-and-the-marshfield-clinic-form-the-premier-rural-health-system/) - Transaction Announcement Marshfield Clinic Health System (MCHS), a physician-led integrated health system serving rural Wisconsin and Michigan’s Upper Peninsula, and Sanford Health, headquartered in Sioux Falls, South Dakota, have successfully completed their partnership, creating the largest rural health system in the United States. This collaboration merges their strengths to enhance healthcare delivery in underserved rural
- [Special Report: Healthcare M&A Predictions for 2025](https://juniperadvisory.com/special-report-healthcare-ma-predictions-for-2025/) - Read what trends our team believes will shape the healthcare industry and M&A market next year. They share thoughts on the macro-operating environment for hospitals and trends in acute care system consolidation. Several themes emerge. Welcome to 2025. Avoidable hospital transaction failures will continue Casey Webb During the past five years, more than 10% of
- [Blount Memorial Hospital officially joins Prisma Health](https://juniperadvisory.com/blount-memorial-hospital-officially-joins-prisma-health/) - Blount Memorial Hospital and Blount County, Tennessee have completed their partnership with Prisma Health. Juniper was pleased to advise on the ~$365 million lease transaction. Our team enjoyed working alongside: Blount Memorial Hospital - - Jonathan Smith, Chris Flynn Prisma Health - - Mark O'Halla, Alexander Gladney, Malcolm Isley, Clarence Sevillian Bass, Berry & Sims - -
- [2024 Nashville Healthcare Sessions Conference](https://juniperadvisory.com/2024-nashville-healthcare-sessions-conference/) - Our team is pleased to attend the 2024 Nashville Healthcare Sessions Conference at the iconic Country Music Hall of Fame. Let us know if you’ll be attending so we can connect! This event brings together industry leaders, innovative start-ups, and healthcare experts for meaningful conversations about the future of healthcare. With over 80 executive speakers,
- [Marshfield Clinic Health System and Sanford Health Announce Definitive Agreement to Form a Premier Rural Health System](https://juniperadvisory.com/marshfield-clinic-health-system-and-sanford-health-announce-definitive-agreement-to-form-a-premier-rural-health-system/) - Transaction Announcement Sanford Health, headquartered in Sioux Falls, South Dakota, and Marshfield Clinic Health System, a physician-led integrated health system serving rural Wisconsin and Michigan’s Upper Peninsula, announced the signing of a definitive merger agreement to form the largest rural health system in the U.S. Since the signing of a Letter of Intent in June,
- [NASA and SpaceX: Observations for Public Hospitals](https://juniperadvisory.com/nasa-and-spacex-observations-for-public-hospitals/) - Government-owned hospitals face unique organizational challenges. In the latest public focus article, Chris Benson, Executive Director, and Rex Burgdorfer, Partner, Juniper Advisory, draw observations from NASA and SpaceX for public hospitals navigating complex conditions. 📢 Key Takeaways for Boards and Leaders of Governmental Hospitals: - Collaborate for Scale: Seek partnerships to leverage the benefits of
- [Why a health system’s growth strategy should include a build-versus-buy analysis](https://juniperadvisory.com/why-a-health-systems-growth-strategy-should-include-a-build-versus-buy-analysis/) - What’s driving health systems' growth strategies in 2024? A build-versus-buy analysis is now essential as health systems navigate escalating construction costs and tighter capital markets. In the latest edition of hfm magazine, Adam Davis, Vice President at Juniper Advisory, explores how health systems are approaching this decision. By weighing risks like construction costs, market conditions,
- [Lawrence General Hospital Expands Community Care with Acquisition of Steward Health Care’s Holy Family Hospitals](https://juniperadvisory.com/lawrence-general-hospital-expands-community-care-with-acquisition-of-steward-health-cares-holy-family-hospitals/) - Transaction Announcement Lawrence General Hospital (LGH), a prominent non-profit safety net hospital with a nearly 150-year legacy serving the Merrimack Valley community, has successfully acquired Holy Family Hospitals (HFH) located in Methuen and Haverhill, Massachusetts. Juniper Advisory is pleased to have advised LGH throughout this complex and strategic transaction. This acquisition presents a unique opportunity
- [2024 Minnesota Hospital Association Annual Meeting](https://juniperadvisory.com/2024-minnesota-hospital-association-annual-meeting/) - Our team was pleased to attend the 2024 Minnesota Hospital Association Annual Meeting. This high energy event brought together top executives from hospitals and health systems to talk about challenges and opportunities that hospitals and health systems are weighing today. For more information about Juniper’s work and experience helping health systems explore partnerships, contact Chris
- [Juniper Advisory Welcomes Eleanor Smith](https://juniperadvisory.com/juniper-advisory-welcomes-eleanor-smith-director-of-client-coverage-and-business-development/) - We’re pleased to welcome our newest team member, Eleanor Smith. Eleanor will lead business development, client coverage and marketing efforts for Juniper. She has more than 20 years of experience serving as both Managing Director and Chief Client Officer for two national law firms, including growing the healthcare and life sciences practices specifically. Eleanor also recently
- [Band-Aid Station or Tertiary Center? The Impact of Consolidation on Community Hospital Services](https://juniperadvisory.com/band-aid-station-or-tertiary-center-the-impact-of-consolidation-on-community-hospital-services/) - Juniper Advisory delves into the impact of hospital consolidation on access to care, offering new insights into the debate over local control versus system affiliation. Jordan Shields, Partner, examines how joining larger health systems affects access and complexity of care. Amid concerns that consolidation might reduce local services, the article reveals that compared to standalone
- [Juniper Advisory Welcomes Analyst Alexander Norton](https://juniperadvisory.com/juniper-advisory-welcomes-analyst-alexander-norton/) - We’re pleased to welcome our newest team member, Alexander Norton. Alex will focus on analytics and transaction execution for Juniper’s health system M&A clients. Previously he was with The Edgewater Funds, a private equity firm affiliate of Lazard asset management in which he focused on the healthcare industry. He holds a BA in economics and history from
- [2024 Texas Healthcare Trustees Healthcare Governance Conference](https://juniperadvisory.com/2024-texas-healthcare-trustees-healthcare-governance-conference/) - Chris Benson, Executive Director, Juniper Advisory and Todd Linden, Partner, Linden Consulting, discussed: Leading with Impact: Best Practices for High-Performing Board Chairs Real World Board Governance: Expert Insights and Open Q&A For more information about Juniper’s work and experience in advising health systems, contact Chris Benson at 312-516-3000 or cbenson@juniperadvisory.com. Juniper Advisory is pleased to
- [2024 American Hospital Association Annual Membership Meeting](https://juniperadvisory.com/2024-american-hospital-association-annual-membership-meeting/) - Our team was pleased to attend the 2024 American Hospital Association Annual Membership Meeting in the heart of our nation’s capital this week! At this pivotal gathering, we had the chance to connect directly with decision-makers who shape healthcare policy and influence the political landscape. It was three days packed with insightful discussions, networking opportunities,
- [American Health Law Association 2024 Health Care Transactions Program](https://juniperadvisory.com/american-health-law-association-2024-health-care-transactions-program/) - Our team is pleased to present at the American Health Law Association 2024 Health Care Transactions Program in Nashville this month. Brent McDonald, Managing Director, Juniper Advisory, and Torrey McClary, Partner, Ropes & Gray LLP, will present We Are Never Ever Getting Back Together: Strategies to Create Lasting Relationships and Avoid Heartbreak in your M&A
- [Juniper Advisory Promotes Ansley Murphy to Associate](https://juniperadvisory.com/3003-2/) - We are pleased to announce the promotion of Ansley Murphy to Associate. Since joining Juniper Advisory from Ernst & Young (EY), Ansley has been a valuable asset to our Firm. We are confident that she will continue to excel in her new role delivering exceptional client service. Congratulations, Ansley! Your promotion is well-deserved, and we
- [A Healthcare Leader’s Guide to Successful Mergers and Acquisitions – New Audio Series](https://juniperadvisory.com/a-healthcare-leaders-guide-to-successful-mergers-and-acquisitions-new-audio-series/) - We are pleased to announce our new audio series, "A Healthcare Leader's Guide to Successful Mergers and Acquisitions.” Anyone who has lived through a hospital or health system merger or acquisition can attest to a transaction’s complexity. As a result, episode topics are highly varied, including Board-level Governance issues, M&A tactics, capital structure considerations, process
- [Juniper Advisory Welcomes Summer Analyst David Jin](https://juniperadvisory.com/juniper-advisory-welcomes-summer-analyst-david-jin/) - Juniper is pleased to continue our summer internship program in 2024. This year, we welcome David Jin, who joins us following his Junior year at Colby College. He has worked at Mayflower Hill Capital, CBRE Capital Markets and is fluent in Chinese. We look forward to his contributions this summer!
- [Blount Memorial Hospital in Blount County, TN to join Prisma Health](https://juniperadvisory.com/blount-memorial-hospital-in-blount-county-tn-to-join-prisma-health/) - Transaction Announcement The Blount Memorial Hospital (BMH) Board of Directors and the Blount County Board of Commissioners have each approved entering into a non-binding letter of intent with Prisma Health that provides for Blount Memorial Hospital to become part of Prisma Health later this year. The strategic decision was approved following unanimous votes from both
- [Genesis Health System and MercyOne Complete Partnership](https://juniperadvisory.com/genesis-health-system-and-mercyone-complete-partnership/) - Transaction Announcement Genesis Health, a five-hospital system serving 17 counties in Eastern Iowa and Western Illinois, has joined MercyOne. MercyOne is part of Trinity Health, headquartered in Livonia, Michigan, one of the largest healthcare systems in the country with 88 hospitals across 26 states. "As part of MercyOne, Genesis will be able to leverage the skill, talent
- [Mid-Columbia Medical Center Joins Adventist Health](https://juniperadvisory.com/mid-columbia-medical-center-joins-adventist-health/) - Transaction Announcement Mid-Columbia Medical Center (MCMC) located in The Dalles, OR has joined Adventist Health headquartered in Roseville, CA. MCMC sits in the Columbia River Gorge market, ~85 miles east of Portland. This is the first hospital transaction approved by the Oregon Health Authority’s new Healthcare Market Oversight program. MCMC initiated a process to assess strategic alternatives
- [Gerald Champion Regional Medical Center Joins CHRISTUS Health](https://juniperadvisory.com/gerald-champion-regional-medical-center-joins-christus-health/) - Transaction Announcement Gerald Champion Regional Medical Center (GCRMC) located in Alamogordo, NM has joined CHRISTUS Health headquartered in Irving, TX. Located in the high desert at the base of the Sacramento Mountains near both the White Sands National Park and Holloman Airforce Base, GCRMC has served the needs of South Central New Mexico since 1949.
- [Quorum Health Completes Transaction with Java Medical Group](https://juniperadvisory.com/quorum-health-completes-transaction-with-java-medical-group/) - Transaction Announcement Quorum Health Corporation, headquartered in Brentwood, TN, has transferred ownership of Fannin Regional Hospital to Java Medical Group, located in Nashville, TN. Fannin Regional Hospital is a short-term acute care hospital located in Blue Ridge, GA, serving its community since 1977. It has a geographically diverse patient population that spans from Fannin County,
- [The Formation of Michigan's Newest Health System](https://juniperadvisory.com/the-formation-of-michigans-newest-health-system/) - Aspire Rural Health Three hospitals in the Thumb of Michigan have combined to form Aspire Rural Health. Hills & Dales Healthcare, Marlette Regional Hospital, and Deckerville Community Hospital affiliates of United Healthcare Partners, consolidated to create a new system of care in the region. The partnership is designed to preserve local control and autonomy while increasing scale and integration. The
- [Marshfield Clinic Health System and Sanford Health Announce Intent to Combine](https://juniperadvisory.com/marshfield-clinic-health-system-and-sanford-health-announce-intent-to-combine/) - Transaction Announcement Sanford Health, the largest rural health system in the U.S., headquartered in Sioux Falls, South Dakota, and Marshfield Clinic Health System, a physician-led integrated health system serving rural Wisconsin and Michigan’s Upper Peninsula, today announced a nonbinding Memorandum of Understanding to combine their complementary assets and capabilities and create an integrated health system
- [Liberty Hospital joins The University of Kansas Health System](https://juniperadvisory.com/liberty-hospital-joins-the-university-of-kansas-health-system/) - Transaction Announcement New Liberty Hospital District (Liberty) in Liberty, Missouri, has completed its partnership with The University of Kansas Health System (UKHS). Juniper was pleased to advise Liberty on the transaction. As part of consideration, UKHS committed to invest $324 million in capital projects to grow clinical services, fund facility improvements, infrastructure, and information technology
- [Holland & Knight Counsel That Cares Podcast - Hospital M&A Trends & Strategic Considerations for 2024](https://juniperadvisory.com/holland-knight-counsel-that-cares-podcast-hospital-ma-trends-strategic-considerations-for-2024/) - In this episode of "Counsel That Cares," healthcare attorney Colin Luke examines transactions for hospitals and health systems, as well as what's driving that activity across the country with hospitals and health systems, partnering, acquisitions and sales. Mr. Luke is joined by Rex Burgdorfer, a partner at Juniper Advisory, which is an investment bank that partners with hospitals and
- [Current Trends in Hospital Mergers and Acquisitions](https://juniperadvisory.com/current-trends-in-hospital-mergers-and-acquisitions/) - Healthcare reform will result in more consolidation and integration among hospitals, reversing a recent trend in which hospitals tended to stay away from such transactions. Regardless of the ultimate fate of the Affordable Care Act, healthcare reform is becoming a powerful catalyst for consolidation and integration in the hospital industry. At a Glance: Healthcare reform will
- [Hospital M&A Transactions: A Focus on Retiring Liabilities](https://juniperadvisory.com/hospital-ma-transactions-a-focus-on-retiring-liabilities/) - The volume of business combinations involving non-profit hospitals is at the highest level of the last decade. The macro-economic forces spurring industry consolidation and rationalization are weighing heavily on management teams and boards around the United States. There is broad consensus that the fragmented ownership structure of the acute-care industry is, in part, responsible for
- [AHA Trustee Insights - Transforming Governance: From Surviving to Thriving](https://juniperadvisory.com/aha-trustee-insights-from-surviving-to-thriving/) - The board’s obligation is to consider all options to achieve its mission, including gleaning lessons from the movie “Grease!” BY CHRIS BENSON, DENISE LAMPHIER AND TODD LINDEN With the well-documented headwinds of workforce issues and cost inflation leading to significant financial challenges, what is a community hospital board to do? One consideration is affiliation with
- [Minnesota Hospital Association 2024 Winter Trustee Conference](https://juniperadvisory.com/minnesota-hospital-association-2024-winter-trustee-conference/) - Thank you to Rahul Koranne and the Minnesota Hospital Association team for hosting such an engaging conference. Chris Benson, FACHE, CMPE, Executive Director, Juniper Advisory & Todd Linden, Partner, Linden Consulting, presented… From Surviving to Thriving: The Leader’s Obligation to Consider All Affiliation Options With the well-documented headwinds of workforce issues and cost inflation leading to significant financial challenges, what is a
- [2024 AHA Rural Health Care Leadership Conference](https://juniperadvisory.com/2024-aha-rural-health-care-leadership-conference/) - Our team was pleased to present at the 37th Annual AHA Rural Health Care Leadership Conference in Orlando. Chris Benson, FACHE, CMPE, Executive Director, Juniper Advisory, Dennis Knox, President & CEO, Adventist Health Columbia Gorge, and Todd Linden, President, Linden Consulting, presented Transforming to Thrive: Insights on Governance and Process Imperatives when Exploring Affiliations. Juniper Advisory is pleased to be
- [42nd Annual J.P. Morgan Healthcare Conference](https://juniperadvisory.com/42nd-annual-j-p-morgan-healthcare-conference/) - Our team is pleased to kick off the new year at the 42nd Annual J.P. Morgan Healthcare Conference in San Francisco this week. Great to engage with healthcare colleagues, partners, and like-minded professionals. Always the perfect ecosystem to make valuable connections. There was a theme of cautious optimism among attendees about 2024. Here’s to a
- [Special Report: Healthcare M&A Predictions for 2024](https://juniperadvisory.com/special-report-healthcare-ma-predictions-for-2024/) - Read what trends our team believes will shape the healthcare M&A market and hospital industry next year. They share thoughts on performance, headwinds, trends in business combinations, and issues across the macro health system environment. Several clear themes emerged. Welcome to 2024. More distressed acquisitions due to persistent operating pressures Adam Davis Expense challenges will
- [Post-COVID-19 Future of U.S. Health Care](https://juniperadvisory.com/post-covid-19-future-of-u-s-health-care/) - by Brian Fuller, Principal, PYA and Jordan Shields, Partner, Juniper Advisory How boards can prepare for an evolving landscape. The COVID-19 pandemic has challenged our nation over the past two years. The way hospitals led, and continue to lead, pandemic response in their communities demonstrate a fact many know to be true: No
- [A Glimmer of Hope for Rural Obstetrics](https://juniperadvisory.com/a-glimmer-of-hope-for-rural-obstetrics/) - Juniper Advisory suggests an innovative approach to address the growing crisis in access to obstetrics services. Jordan Shields, Partner, Casey Webb, Managing Director, and Duncan Cannon, Analyst, assess the challenges that have resulted in dwindling access and identify an overlooked solution. The emerging obstetrics crisis paints a bleak picture for access to maternity and childbirth
- [Juniper Advisory Adds Farley Reardon to its Health System M&A Advisory Group in Nashville](https://juniperadvisory.com/juniper-advisory-adds-farley-reardon-to-its-health-system-ma-advisory-group-in-nashville/) - We are pleased to announce the addition of Farley Reardon as Managing Director in Juniper Advisory's health system M&A Advisory group in Nashville. "I have worked with Juniper for over a decade and across the country on a range of strategic growth initiatives," said Mr. Reardon. "Juniper stands out as the most tenured team in the industry, advising
- [Health New Illinois Event - Partnering Up](https://juniperadvisory.com/health-new-illinois-event-partnering-up/) - Jordan Shields, Partner, Juniper Advisory, will be joining Dr. Jeff Bahr, MD, FACP, Midwest Regional President, Advocate Health Medical Group, Claire Jones Anderson, Deputy Bureau Chief of Legislative Affairs, Illinois Attorney General's Office and Emily Shields, Vice President of Business Development, OSF HealthCare to discuss how mergers and acquisitions are impacting the healthcare landscape in
- [HFMA New Mexico Fall Conference](https://juniperadvisory.com/hfma-new-mexico-fall-conference/) - We were pleased to participate in the Mergers and Acquisitions Transition Panel titled “Change Management: How to Survive and Thrive” at the HFMA New Mexico Fall Conference. The conference's theme, "Future of Healthcare: Becoming Agents of Change," truly captured what the healthcare industry needs in this ever-changing environment. The conference offered great content and resources
- [Nashville Healthcare Sessions Conference](https://juniperadvisory.com/nashville-healthcare-sessions-conference/) - Our team was pleased to be a part of the Nashville Health Care Council's inaugural Nashville Healthcare Sessions conference! With industry leaders, innovative start-ups, and healthcare experts coming together, it's been an incredible opportunity to connect and learn about the future of healthcare and Nashville's role in moving the industry forward. Learn More
- [Is your Health System Team Ready for What's Next? A Recession or More Malaise?](https://juniperadvisory.com/is-your-health-system-management-team-ready-for-whats-next-a-recession-or-more-malaise/) - By Adam Davis, Vice President, and Brent McDonald, Managing Director, Juniper Advisory Bart Walker, Partner, and Kayla McCann Marty, Partner, McGuireWoods Today’s State of Affairs Coming out of the pandemic, health systems in the US have been dealing with a prolonged period of operational disruption driven by increased labor costs, supply chain issues and soft
- [Juniper Advisory Promotes Casey Webb to Managing Director](https://juniperadvisory.com/juniper-advisory-promotes-casey-webb-to-managing-director/) - Juniper Advisory is pleased to announce the promotion of Casey Webb to Managing Director. "Casey has been an integral part of Juniper's transaction advisory team since 2020, joining the firm with over a decade of industry experience and immediately meshing with our Firm's culture," said Rex Burgdorfer, Partner at Juniper Advisory. In her new role as Managing Director, Casey
- [McGuireWoods The Corner Series Podcast - Hospital M&A and Private Equity with Rex Burgdorfer](https://juniperadvisory.com/the-corner-series-podcast-hospital-ma-and-private-equity-with-rex-burgdorfer/) - The healthcare system is one of the most fragmented industries in the United States. But as strategic players begin consolidating through mergers and acquisitions, private equity investors are seeing growth opportunities in the industry. On this episode of The Banker's Corner, McGuireWoods' Geoff Cockrell invites Rex Burgdorfer, Partner at Juniper Advisory, to discuss M&A trends,
- [American Hospital Association Leadership Summit](https://juniperadvisory.com/american-hospital-association-leadership-summit/) - Our team had the privilege of joining healthcare leaders from across the country at the American Hospital Association Leadership Summit. We appreciated the chance to hear from provocative thought leaders like Paul Keckley, Nathan Kaufman, Ian Morrison, and so many others. Juniper Advisory is pleased to be an Associate of the American Hospital Association and proud to support its
- [Consolidation in Commercial Banking Offers a Glimpse of Health Care's Future](https://juniperadvisory.com/consolidation-in-commercial-banking-offers-a-glimpse-of-health-cares-future/) - Payment reform poses a seemingly endless list of complex, interrelated questions. For the trustees and executives responsible for guiding their institutions through this unfamiliar terrain, the best answers to those questions often can be found in another industry. The commercial banking and hospital fields have much in common. Both are service providers in low-margin, capital-intensive,
- [Consolidation Transactions: Will They Make a Comeback?](https://juniperadvisory.com/consolidation-transactions-will-they-make-a-comeback/) - The recent combination of two suburban Chicago hospitals represents the reappearance of a transaction structure that has been rarely used since the 1990s. Central DuPage Hospital and Delnor Hospital have combined via a consolidation transaction, each becoming part of a newly created parent company. This transaction is similar to many business combinations that occurred in
- [Public Hospitals and Partnerships](https://juniperadvisory.com/public-hospitals-and-partnerships/) - 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 continue to make investments in information technology, administration and care, but also take on additional financial risk. At the same time, other challenges abound: slowing
- [Developing a Hospital Transaction Strategy and Process](https://juniperadvisory.com/developing-a-hospital-transaction-strategy-and-process/) - Pursuing a transaction is among the most significant actions that a hospital board and management team can undertake in the life of an institution. It also is the riskiest. Economic and non-economic stakes are high, including preserving the hospital’s mission and charitable objectives, safeguarding access to care, ensuring quality and protecting employees. A well-run merger
- [Protecting Corporate Value in Affiliation Transactions](https://juniperadvisory.com/protecting-corporate-value-in-affiliation-transactions/) - Hospital leaders are increasingly interested in affiliations, or relationships with other healthcare organizations that do not involve ownership changes. Affiliations can take many forms, including management agreements, clinical affiliations, purchasing cooperatives, and joint operating agreements. But they also pose unique risks. Community hospitals often pursue affiliations rather than mergers or outright sales, for instance, to
- [The Expanding Range of Strategic Alternatives in Hospital System M&A](https://juniperadvisory.com/the-expanding-range-of-strategic-alternatives-in-hospital-system-ma/) - The business of governing acute care health systems has become increasingly complex in recent years as board governance and industry structure have worked to keep up with the pace of reform and consolidation. The sector has evolved from a largely charitable function to a major industry that comprises 5 percent of the gross domestic product.
- [Texas Healthcare Trustees Healthcare Governance Conference](https://juniperadvisory.com/texas-healthcare-trustees-healthcare-governance-conference/) - Our team had the honor of presenting at the Texas Healthcare Trustees Healthcare Governance Conference. Chris Benson, Executive Director, Juniper Advisory & Todd Linden, Partner, Linden Consulting, discussed… From Surviving to Thriving: The Leader’s Obligation to Consider All Affiliation Options With the well documented headwinds of workforce issues and cost inflation leading to significant financial
- [Cross-Market Health System Consolidation in a Challenged Industry](https://juniperadvisory.com/cross-market-health-system-consolidation-in-a-challenged-industry/) - By Adam Davis, Vice President, and Rex Burgdorfer, Partner, Juniper Advisory As health systems continue to tackle the ongoing pressures placed on the healthcare delivery system driven by consumerism, value-based care, payer reimbursement issues, labor shortages, and a myriad of other challenges, senior leadership and boards are engaging in more strategic discussions and creative pathways
- [2023 Summer Reading List](https://juniperadvisory.com/2023-summer-reading-list/) - It’s time to kick back and relax with a book or two! We’ve put together the perfect reading list for all your summer adventures; whether you’re headed for the beach, the mountains, or a nearby couch, these books will be excellent additions to your collection! Here is what our team will be reading this summer…
- [American Health Law Association Health Care Transactions](https://juniperadvisory.com/2023-ahla-health-care-transactions/) - We were pleased to have the opportunity to attend the AHLA Health Care Transactions program! There was a great deal of insightful information presented as to mergers, acquisitions, joint ventures, and other health care transactions and the critical business considerations that must be addressed before, during, and after closing. As always, AHLA and the sponsors
- [American Hospital Association Annual Membership Meeting](https://juniperadvisory.com/2023-aha-annual-membership-meeting/) - Our team had the privilege of participating in the 2023 AHA Annual Membership Meeting in Washington D.C. this week. It was an honor to meet and engage with so many hospital system leaders. Juniper Advisory is pleased to be an Associate of the American Hospital Association and proud to support its mission.
- [Minnesota Hospital Association Health Care Leadership Institute](https://juniperadvisory.com/minnesota-hospital-association-health-care-leadership-institute/) - It was great to have the opportunity to connect with the talented healthcare professionals and innovators who attended the MHA Health Care Leadership Institute this year! Juniper Advisory is pleased to partner with the Minnesota Hospital Association and proud to support its mission to advance community health through leadership, advocacy, and collaboration.
- [Juniper Advisory Welcomes Analysts Alex Cheng and Ansley Murphy](https://juniperadvisory.com/juniper-advisory-welcomes-analysts-alex-cheng-and-ansley-murphy/) - Juniper Advisory is excited to welcome two new analysts to our team. Alex Cheng joins from Alvarez & Marsal, NewYork-Presbyterian Hospital and Columbia University. Ansley Murphy, CPA, joins from EY, Vaco and the University of Georgia - J.M. Tull School of Accounting. Alex and Ansley will focus on M&A analytics and transaction execution. We look forward to all the significant contributions and expertise they’ll bring
- [Juniper Advisory Welcomes Summer Analyst Joseph Ames](https://juniperadvisory.com/juniper-advisory-welcomes-summer-analyst-joseph-ames/) - We’re pleased to welcome Joseph Ames to the Juniper team! Joe, our Investment Banking Summer Analyst Intern, is a student at Stevens Institute of Technology studying Finance, Computer Science, and Accounting, where he is also the Co-President and Co-Founder of the Finance Society. Joe was previously with Ros Capital Partners as a Private Equity Analyst and has completed an Economic Development
- [Juniper Advisory Open House Event](https://juniperadvisory.com/juniper-advisory-open-house-event/) - Coming to Becker's Chicago Conference? We Invite You to Join Us on April 4th. Select the Invitation below to RSVP. We hope to see you there!
- [Webinar Series - Hospital Mergers, Acquisitions and Partnerships: Perspectives and Execution Strategies](https://juniperadvisory.com/hospital-mergers-acquisitions-and-partnerships-perspectives-and-execution-strategies/) - We want to thank the Louisiana Hospital Association for allowing our team to be part of their mission to support LHA members through advocacy, education, and services. In August, Brent McDonald, Jordan Shields, and Adam Davis finished a 3-part educational initiative with LHA. The webinar series described national trends, headwinds facing hospitals, and the complexity of dealing
- [Webinar - Stakeholder Management during the Partnership Process](https://juniperadvisory.com/webinar-stakeholder-management-during-the-partnership-process/) - We want to thank The Governance Institute for including us in this program and allowing our team to be part of their mission to serve not-for-profit hospital and health system boards of directors, executives, and physician leadership through research and publications, online learning, conferences, and advisory services. Webinar Overview This Webinar will present a case
- [2022 Summer Reading List](https://juniperadvisory.com/2022-summer-reading-list/) - SUMMER STARTS TODAY!!! Let’s kick it off with a vacation-worthy reading list! Whether you’re headed for the beach, the mountains, or a nearby couch, these books will be excellent additions to your collection! Here is what our team will be reading this summer… - “The Next Shift: The Fall of Industry and the Rise of
- [Casey Webb Announced as Recipient of The 13th Annual Emerging Leaders Award](https://juniperadvisory.com/casey-webb-announced-as-recipient-of-the-13th-annual-emerging-leaders-award/) - Chicago, Illinois, June 28, 2022 - The M&A Advisor announced Casey Webb, Executive Director at Juniper Advisory as one of the recipients of the 13th Annual Emerging Leaders Awards. The M&A Advisor, renowned globally for its recognition and presentation of leading M&A, financing and turnaround professionals, created this recognition awards program to promote mentorship and professional
- [Dr. Jonathan Fanton joins Juniper Advisory as a Senior Advisor](https://juniperadvisory.com/dr-jonathan-fanton-joins-juniper-advisory-as-a-senior-advisor/) - Juniper Advisory announces that Dr. Jonathan Fanton has joined the firm as a Senior Advisor where he will supplement the team focused on providing merger and acquisition advisory services to the higher education sector. Dr. Fanton is President Emeritus of the American Academy of Arts & Sciences. He served as Interim Director of the Roosevelt House
- [Special Report: Healthcare M&A Predictions for 2023](https://juniperadvisory.com/special-report-healthcare-ma-predictions-for-2023/) - Read what forces our team believes will shape the healthcare M&A industry next year. They share thoughts on challenges, investing, partnerships, trust, the media – and what gets them up in the morning when they think about healthcare. Several clear themes emerged. Welcome to 2023. 1. What forces will be driving hospital M&A in
- [Dealmaking in the Sunlight: Navigating Public Hospital M&A](https://juniperadvisory.com/dealmaking-in-the-sunlight-navigating-public-hospital-ma/) - Public hospitals have a uniquely open relationship to the communities they serve, which invites a level of transparency as they consider potential mergers and acquisitions. So what kind of M&A deal activity options are out there for public hospitals dealing with financial pressures, and how can parties navigate regulatory, financial and public opinion to get
- [Assessing Hospital Financial Viability in a Period of Economic Disruption](https://juniperadvisory.com/assessing-hospital-financial-viability-in-a-period-of-economic-disruption/) - By Adam Davis, Vice President, Juniper Advisory Operating environments for hospitals and health systems are vastly different when comparing 2021 to 2022. The enduring impacts of the COVID-19 pandemic have caused operational disruptions that have severely strained the U.S. healthcare system and outlasted roughly two years’ worth of government stimulus. The stark difference in just
- [Health Systems’ Financials Look Very Different in 2022](https://juniperadvisory.com/health-systems-financials-look-very-different-in-2022/) - By Adam Davis, Vice President, Juniper Advisory Operating environments for hospitals and health systems in the US are vastly different when comparing 2021 to year-to-date 2022. The enduring impacts of the COVID-19 pandemic have caused operational disruptions that have severely strained the US healthcare system and outlasted roughly two years’ worth of government stimulus funding.
- [Assessing Independence & Strategic Options for Higher Education Institutions](https://juniperadvisory.com/assessing-independence-strategic-options-for-higher-education-institutions/) - This article offers board members and executive teams of universities and colleges guidance in weighing alternatives to best position their organizations for future success. As the landscape of higher education evolves, leaders are increasingly taking proactive steps to review their strategic positions to ensure their universities’ long-term vitality. While this process is critical for institutions
- [Hospital Partnerships, Mergers & Acquisitions—We Wrote the Book](https://juniperadvisory.com/hospital-partnerships-mergers-acquisitions-we-wrote-the-book/) - Navigating a hospital M&A process can be complex and daunting. Juniper can help. Our new book for hospital Boards and executives offers a start-to-finish look at what it takes to successfully complete a healthcare partnership. The book includes articles from Juniper and leading partners in the field about partnership evaluations, transaction structures, legal considerations, communications
- [Non-Profit Hospital Boards and the Merger Market](https://juniperadvisory.com/non-profit-hospital-boards-and-the-merger-market/) - During this decade, non-profit boards have been confronted increasingly with the potential for merger and change-of-control (“merger market”) transactions. There has been a dramatic increase in the need for non-profit organizations to consider macroeconomic industry conditions and the resultant role of the merger market. Hospital and health system boards of directors must be proactive and
- [James Burgdorfer Quoted in the Wall Street Journal](https://juniperadvisory.com/james-burgdorfer-quoted-in-the-wall-street-journal/) - Juniper's James Burgdorfer was quoted in the Wall Street Journal article "Cash-Poor Governments Ditching Public Hospitals", which was published on August 29, 2010. Faced with mounting debt and looming costs from the new federal health-care law, many local governments are leaving the hospital business, shedding public facilities that can be the caregiver of last resort.
- [The Board's Role in the M&A Process: Meeting Fiduciary Obligations](https://juniperadvisory.com/the-boards-role-in-the-ma-process-meeting-fiduciary-obligations/) - Chances are that most non-profit hospital boards will be called upon to evaluate a merger/acquisition proposal at some point in the very near future. Healthcare reform is prompting hospitals across the country to reevaluate their market strength and competitive posture given the new regulatory dynamic. Local healthcare markets are increasingly fluid, as providers and physician groups are anxiously wondering whether
- [New Models for Community Hospital Joint Ventures](https://juniperadvisory.com/new-models-for-community-hospital-joint-ventures/) - Joint ventures between investor-owned and nonprofit health care organizations are not new; in fact, they have occurred for at least 25 years. Until recently, nonprofits were employing this type of transaction to address their need for capital without "selling out" and losing control over a vital community asset. The joint venture structure provided nonprofits with
- [James Burgdorfer Interviewed in "Nonprofits Weigh Benefits of Buyer Joint Ventures"](https://juniperadvisory.com/james-burgdorfer-interviewed-in-nonprofits-weigh-benefits-of-buyer-joint-ventures/) - James Burgdorfer was interviewed in the January 2, 2013 HealthLeaders Media article "Nonprofits Weigh Benefits of Buyer Joint Ventures." In the interview article, Jamie explains how nonprofit hospital systems are actively evaluating alternative transaction structures as a means to bolster and finance their acquisition programs. Juniper has been very active in 2013 advising several large
- [James Burgdorfer Quoted in Modern Healthcare Report on Innovative Hospital Partnerships](https://juniperadvisory.com/james-burgdorfer-quoted-in-modern-healthcare-report-on-innovative-hospital-partnerships/) - Juniper's James Burgdorfer was quoted in the Modern Healthcare article "Taking a different path," which outlined the increasing frequency of ownership partnerships between non-profit hospitals and for-profit healthcare companies. As health systems prepare for a healthcare reimbursement environment that places more emphasis on quality and continuity of care and less on fee-for-service payment, hospital executives
- [Wisconsin HFMA CFO Forum](https://juniperadvisory.com/wisconsin-hfma-cfo-forum/) - Barry Sagraves co-presented on the Mergers, Acquisitions, and Affiliating Panel for the 5th Annual Wisconsin HFMA CFO Forum in Milwaukee, WI. The panel discussed how health reform and other macro-economic trends are causing both horizontal and vertical provider integration. For more information about the HFMA and its related programming, follow this link.
- [Marquette General Health System Featured on Fox TV6](https://juniperadvisory.com/marquette-general-health-system-featured-on-fox-tv6/) - MGH in Michigan's Upper Peninsula Juniper client Marquette General Health System was featured in a recent Fox TV6 television news story which provided a six month update on the accomplishments of the system after they entered into a roughly $500 million transaction with Duke LifePoint in 2012. This was the largest rural transaction in history
- [Becker's Hospital Review 2013 Annual Meeting](https://juniperadvisory.com/beckers-hospital-review-2013-annual-meeting/) - James Burgdorfer spoke on a panel titled “Collaborations between academic medical centers, 501(c)3’s, and investor owned systems” at the Becker's Hospital Review 2013 Annual Meeting. The event was held in Chicago from May 9-11, 2013. Fellow panelists included Scott Powder, Vice President of Strategic Planning and Growth at Advocate Health Care, and Pete Lawson, Executive
- [Juniper Advises Ludington's Memorial Medical Center of West Michigan](https://juniperadvisory.com/juniper-advises-ludingtons-memorial-medical-center-of-west-michigan/) - Memorial Medical Center of West Michigan, a 73-bed nonprofit regional medical center based in Ludington, MI, has signed a non-binding letter of intent to partner with Spectrum Health, a nonprofit West Michigan health system based in Grand Rapids, MI. The announcement comes after a nationwide search and evaluation of potential partners and partnership models, which
- [American Law Institute Webinar](https://juniperadvisory.com/american-law-institute-webinar/) - Rex Burgdorfer presented a webinar titled “Hospital and Health Systems Transactions: 10 Key Legal and Business Issues” with McGuireWoods partners Scott Becker, Geoff Cockrell, and Holly Carnell at a Health Law Seminar for the American Law Institute. Rex and his co-presenters provided a systematic review of important issues that clients must consider when entering into
- [Consolidation in the Commercial Banking and Hospital Industries](https://juniperadvisory.com/consolidation-in-the-commercial-banking-and-hospital-industries/) - Banks have become so large that many critics view them as unmanageable, too large for government bailout, or too big to fail. Alternatively, the highly fragmented hospital industry is accused of contributing to the excessive cost and mediocre effectiveness of the healthcare services industry. This article considers the disparate approaches taken to industry consolidation by
- [Multi-State Non-Profit Health Systems: Why There Are Not More, but Soon Will Be](https://juniperadvisory.com/multi-state-non-profit-health-systems-why-there-are-not-more-but-soon-will-be/) - After several years of enthusiastic merging and acquiring, multi-hospital systems now own approximately 70 percent of all U.S. hospitals not owned by a government entity. There are more than 400 systems, of which over two-thirds are secular non-profit systems. However, unlike their religious and investor-owned counterparts, almost all of these systems have remained small and
- [Preparing a Hospital or Health System for Sale or Partnership Transaction](https://juniperadvisory.com/preparing-a-hospital-or-health-system-for-sale-or-partnership-transaction/) - The consolidation trend in hospital and health systems continues. At this time, horizontal consolidation (hospital to hospital combinations) are keeping pace with vertical consolidation (hospital acquisitions of ancillary providers and physician groups). To address perceived inefficiencies and quality of care issues, hospitals are attempting to form larger enterprises to create scale, expand geographically, manage risk,
- [Mercy Memorial Hospital System Examining Its Future](https://juniperadvisory.com/mercy-memorial-hospital-system-examining-its-future/) - Monroe News photo by Tom Hawley Juniper has been retained by Monroe, Michigan-based Mercy Memorial Hospital System to conduct a strategic study of the hospital's future options to determine if it should remain independent, seek a partner, or merge with another system. Juniper is working closely with MMHS's board of trustees and senior leadership team
- [Conemaugh Health System Evaluating Strategic Options](https://juniperadvisory.com/conemaugh-health-system-evaluating-strategic-options/) - CHS campus in Johnstown, PA Conemaugh Health System (CHS), a three-hospital, $515 million revenue health system headquartered in Johnstown, PA, has engaged Juniper Advisory to assist in the formalized search for a partner. Juniper is working with the CHS Board and management team to implement a controlled competitive process. The assignment is designed to maximize
- [Rex Burgdorfer Presents at Becker's Hospital Review CEO Strategy Roundtable](https://juniperadvisory.com/rex-burgdorfer-presents-at-beckers-hospital-review-ceo-strategy-roundtable/) - Rex Burgdorfer co-presented "Key Factors Affecting Community Hospital Sales" as part of the annual Becker's Hospital Review CEO Strategy Roundtable, held in Chicago on November 14, 2013. He was joined on the panel by McGuireWoods attorneys Geoffrey Cockrell and Holly Carnell, and the session was moderated by Scott Becker, attorney at McGuireWoods and publisher of
- [Bell Hospital Joins LifePoint Hospitals](https://juniperadvisory.com/bell-hospital-joins-lifepoint-hospitals/) - Bell Hospital, a stand-alone 501(c)3 in Ishpeming, MI, has joined LifePoint Hospitals. This strategic partnership will ensure the future viability of the hospital and maintain healthcare services in the Ishpeming community. As part of the transaction, Bell will retire all of its financial obligations, fund a charitable foundation with the proceeds, and create one of
- [Portage Health and LifePoint Hospitals Form Whole Hospital Joint Venture](https://juniperadvisory.com/portage-health-and-lifepoint-hospitals-form-whole-hospital-joint-venture/) - Portage Health, a stand-alone 501(c)3 hospital in Hancock, MI, has finalized their agreement to form a whole hospital joint venture with LifePoint Hospitals. This transaction is the first joint venture of its kind in the Midwest. The agreement, valued at over $100 million, includes $60 million in capital investments and $40 million to fund a
- [Port Huron Hospital Signs Letter of Intent to Join McLaren Health Care](https://juniperadvisory.com/port-huron-hospital-signs-letter-of-intent-to-join-mclaren-health-care/) - Blue Water Health Services (BWHS), the parent of Port Huron Hospital (PHH), an independent 501(c)3 hospital in Port Huron, MI, has signed a letter of intent to join McLaren Health Care, an integrated nonprofit system based in Flint, MI. The decision was unanimously supported by PHH’s Board of Trustees. McLaren will commit to service growth,
- [Community Health Center of Branch County Launches Search for Strategic Partner](https://juniperadvisory.com/community-health-center-of-branch-county-launches-search-for-strategic-partner/) - Community Health Center of Branch County (CHC), a nonprofit county-owned hospital in Coldwater, MI, has engaged Juniper Advisory to provide strategic advisory services as the hospital launches an exploratory process to search for a strategic partnership with another hospital or health system. CHC’s top priority in selecting a partner is to find an organization that
- [UnityPoint Health Acquires Meriter Health Services](https://juniperadvisory.com/unitypoint-health-acquires-meriter-health-services/) - UnityPoint Health (“UPH”), a 15-hospital system based in Des Moines, IA, has acquired Meriter Health Services based in Madison, WI. Meriter is a fully-integrated $775 million revenue system that includes an acute care hospital, managed care plan, and large physician group. Meriter is UPH’s first hospital in Wisconsin. The partnership represents the continuation of UPH’s
- [Community Hospital Transactions and Affiliations Webinar](https://juniperadvisory.com/community-hospital-transactions-and-affiliations-webinar/) - Jordan Shields co-presented the webinar "Evaluating Transaction Structures and Potential Suitors: Assessing For-Profit and Non-Profit Proposals" as part of the Community Hospital Transactions and Affiliations series, organized by McGuireWoods LLP. Jordan was joined by McGuireWoods attorneys Bart Walker and Holly Carnell. The webinar addressed board level considerations in selecting an appropriate suitor and focused on
- [Jordan Shields Quoted in Becker's Hospital Review's "4 Transaction Models for Community Hospitals"](https://juniperadvisory.com/jordan-shields-quoted-in-beckers-hospital-reviews-4-transaction-models-for-community-hospitals/) - Jordan Shields was quoted in the Becker's Hospital Review article "4 Transaction Models for Community Hospitals," which outlined the range of partnership structures covered in the webinar “Evaluating Transaction Structures and Potential Suitors: Assessing For-Profit and Non-Profit Proposals.” "The majority of our clients right now are very strong, single 'A' rated hospitals with strong cash
- [Joseph Cerreta Interviewed in Becker's Hospital Review's "10 Key Healthcare Transaction Trends"](https://juniperadvisory.com/joseph-cerreta-interviewed-in-beckers-hospital-reviews-10-key-healthcare-transaction-trends/) - Joseph Cerreta was interviewed as part of Becker's Hospital Review's article "10 Key Healthcare Transaction Trends." Joe was joined by other experts in the field of healthcare M&A to weigh in on the recent wave of hospital consolidation and what that might mean for hospital partnerships on a national scale in 2014 and beyond. Commenting
- [Jordan Shields Quoted in Chicago Tribune's "Northwestern Memorial HealthCare, Cadence Health Pursuing Merger"](https://juniperadvisory.com/jordan-shields-quoted-in-chicago-tribunes-northwestern-memorial-healthcare-cadence-health-pursuing-merger/) - Jordan Shields was quoted in the Chicago Tribune article "Northwestern Memorial HealthCare, Cadence Health Pursuing Merger," which announced the systems' signing of a letter of intent to enter into integration talks. The combined system would be comprised of four hospitals, and annual revenue would approach $3 billion. Jordan commented on the possible ramifications of this
- [Conemaugh Health to Partner with Duke LifePoint](https://juniperadvisory.com/conemaugh-health-to-partner-with-duke-lifepoint/) - Conemaugh Health System, a three-hospital, $515 million revenue health system headquartered in Johnstown, PA, has signed a letter of intent to join Duke LifePoint Healthcare, a joint venture between Duke University Health System and LifePoint Hospitals. As part of the transaction, Duke LifePoint has agreed to invest more than half a billion dollars over the
- [The Role of the Nonprofit Hospital Board in Consolidation Transactions](https://juniperadvisory.com/the-role-of-the-nonprofit-hospital-board-in-consolidation-transactions/) - As the hospital consolidation market continues to grow, most consolidation transactions involve nonprofit health systems. Nonprofit boards of directors should prepare well in advance to evaluate consolidation opportunities in a timely and informed manner, consistent with their fiduciary duty. The hospital consolidation market continues to gain steam. The year 2013 saw a total of 87
- [Jordan Shields Quoted in Becker's Hospital Review's "Troubled Transactions: Why There's Still Hope for Financially Struggling Hospitals"](https://juniperadvisory.com/jordan-shields-quoted-in-beckers-hospital-reviews-troubled-transactions-why-theres-still-hope-for-financially-struggling-hospitals/) - Jordan Shields was quoted in the Becker's Hospital Review article "Troubled Transactions: Why There's Still Hope for Financially Struggling Hospitals," which outlined the challenges and possible strategic paths available to a financially compromised independent hospital seeking a partnership. Commenting on transaction volumes specifically, Jordan stated that the number of distressed hospitals looking to carry out
- [Juniper Advisory Assignment a Case Study for Hospital Consolidation in HealthLeaders Media](https://juniperadvisory.com/juniper-advisory-assignment-a-case-study-for-hospital-consolidation-in-healthleaders-media/) - Juniper Advisory's work with Conemaugh Health System, a three-hospital, $515 million revenue health system headquartered in Johnstown, PA, was profiled in the HealthLeaders Media article "Hospital Consolidation Explained in One M&A Deal." The article outlined Conemaugh's recent signing of a letter of intent to join Duke LifePoint Healthcare, a joint venture between Duke University Health
- [Port Huron Hospital Joins McLaren Health Care](https://juniperadvisory.com/port-huron-hospital-joins-mclaren-health-care/) - Port Huron Hospital (PHH), an independent 501(c)(3) hospital in Port Huron, MI, has joined McLaren Health Care, an integrated nonprofit system based in Flint, MI. As part of the agreement, McLaren has committed to very significant capital improvements for the Port Huron community, including the construction of a new cancer center and an inpatient tower.
- [Pennock Health Evaluates Strategic Options](https://juniperadvisory.com/pennock-health-evaluates-strategic-options/) - Pennock Health Services, a standalone nonprofit hospital located in Hastings, MI, has engaged Juniper Advisory in its formalized evaluation of strategic options in order to ensure the community's continued access to high quality health care. Juniper will work with Pennock's Board and leadership team to assess Pennock's current condition and offer potential strategic alternatives and
- [Watertown Regional Medical Center Exploring Partnership Options](https://juniperadvisory.com/watertown-regional-medical-center-exploring-partnership-options/) - Watertown Regional Medical Center (WRMC), an independent nonprofit hospital located in Watertown, WI which maintains a clinical affiliation with UW Health, has announced the initiation of a strategic process to explore whether a health system partner would accelerate WRMC's ability to achieve its long-term vision for the organization. The WRMC Board of Directors has engaged
- [Rex Burgdorfer and Jordan Shields Deliver Keynote at Western Regional Trustee Symposium](https://juniperadvisory.com/rex-burgdorfer-and-jordan-shields-deliver-keynote-at-western-regional-trustee-symposium/) - Rex Burgdorfer and Jordan Shields delivered their keynote address titled "Considering the Role of Industry Structure" for the Western Regional Trustee Symposium, a gathering of hospital board members and executive leadership teams from a collection of 10 western state hospital associations. The keynote provided an overview of the heavily fragmented hospital industry and the ways
- [Jordan Shields Presents at the ACG Chicago Healthcare M&A Conference](https://juniperadvisory.com/jordan-shields-presents-at-the-acg-chicago-healthcare-ma-conference/) - Jordan Shields co-presented "Hospital Systems and Physician Groups: Will the Consolidation Trend Continue?" at ACG Chicago's 5th Annual Healthcare M&A Conference on June 17, 2014 in Chicago. The panel discussed the drivers affecting hospital and physician group consolidation and considered possible trends emerging in the space in 2014 and beyond. ACG Chicago gathers the leading
- [Platte Valley Medical Center Initiates Strategic Options Process](https://juniperadvisory.com/platte-valley-medical-center-initiates-strategic-options-process/) - Platte Valley Medical Center (PVMC), an independent community hospital located in Brighton, CO, a northeast suburb of Denver in the rapidly expanding Front Range region, has announced the initiation of a process to explore a possible affiliation with another healthcare system. The PVMC Board of Directors has engaged Juniper Advisory to assist the Board and
- [Juniper Advisory Profiled by Healthcare Dive](https://juniperadvisory.com/juniper-advisory-profiled-by-healthcare-dive/) - Juniper Advisory was featured in the Healthcare Dive article "6 types of hospital M&A structures execs need to know," which profiled "The Expanding Range of Strategic Alternatives Available in Hospital System Mergers and Acquisitions," an article co-written by Juniper Advisory and the law firm McDermott Will & Emery. In addition to outlining the expanding range
- [Garden City Hospital Joins Prime Healthcare Services](https://juniperadvisory.com/garden-city-hospital-joins-prime-healthcare-services/) - Garden City Hospital, a 167-bed hospital in west-suburban Detroit, has joined Ontario, CA-based Prime Healthcare Services. As part of its commitment to the greater Garden City community, Prime has assumed Garden City’s underfunded pension liability and made a significant forward-looking capital spending guarantee. This is Prime’s first acquisition in the Midwest and represents an exceptional
- [Mercy Memorial Hospital System to Join ProMedica](https://juniperadvisory.com/mercy-memorial-hospital-system-to-join-promedica/) - Mercy Memorial Hospital System (MMHS), a 238-bed nonprofit hospital company located in Monroe, MI, has signed a letter of intent to join ProMedica, a 12-hospital interstate system based in Toledo, OH. The Board of Trustees of MMHS made the unanimous decision to join ProMedica after a rigorous assessment of strategic alternatives. MMHS will become ProMedica’s
- [Juniper Advisory Featured in Trustee Magazine's Partners in Clinical Excellence](https://juniperadvisory.com/juniper-advisory-featured-in-trustee-magazines-partners-in-clinical-excellence/) - Juniper Advisory's Rex Burgdorfer was quoted in the Trustee cover story "Partners in Clinical Excellence," a profile which explored the varying degrees of affiliations available to community hospitals today, including the underlying causes pushing independent hospitals to seek these new partnerships. The discussion included a range of strategies being pursued today, including branded service line
- [Alpena Regional Medical Center Explores Options](https://juniperadvisory.com/alpena-regional-medical-center-explores-options/) - Alpena Regional Medical Center (ARMC), an independent nonprofit hospital located in Alpena, MI, has engaged Juniper Advisory in a formalized assessment of future options as the hospital seeks to ensure the community’s continued access to high quality health care in northeast Michigan. Juniper will work closely with ARMC’s Board and leadership team to assess ARMC’s
- [Webinar: So You've Decided to Explore a Partnership: Now What?](https://juniperadvisory.com/webinar-so-youve-decided-to-explore-a-partnership-now-what/) - Rex Burgdorfer co-presented "So You've Decided to Explore a Partnership: Now What?" for The Governance Institute on Thursday, September 4th from 2:00-3:00pm EST. Rex was joined by Anne Hancock Toomey, Partner at Jarrard Phillips Cate & Hancock, and Scott Becker, CEO of Conemaugh Health System. Using Conemaugh as a case study, the panel looked at
- [Adventist Health to Acquire Lodi Health](https://juniperadvisory.com/adventist-health-to-acquire-lodi-health/) - Adventist Health, a multi-state nonprofit system based in Roseville, CA, has signed a letter of intent to acquire Lodi Health, a fully-integrated health system based in Lodi, CA. Adventist was chosen unanimously by the Lodi Board of Directors after a competitive process which included other major regional systems. Adventist was selected due to its unique
- [Conemaugh Health Joins Duke LifePoint](https://juniperadvisory.com/conemaugh-health-joins-duke-lifepoint/) - Conemaugh Health System, a three-hospital, $515 million revenue health system headquartered in Johnstown, PA, has joined Duke LifePoint Healthcare, a joint venture between Duke University Health System and LifePoint Hospitals. This transaction is the largest in the country to-date involving the emerging buyer joint venture structure. Duke LifePoint has agreed to invest more than half
- [Juniper Advisory Comments on Advocate NorthShore Deal on WGN-TV](https://juniperadvisory.com/juniper-advisory-comments-on-advocate-northshore-deal-on-wgn-tv/) - Juniper Advisory's Rex Burgdorfer appeared on WGN-TV in a piece covering the recently announced Advocate NorthShore partnership. The two organizations will consolidate to form Advocate NorthShore Health Partners, a $6.8 billion system that will be the largest in the state of Illinois. It is expected to serve 3 million patients a year at over 350
- [Juniper Advisory Weighs In on Advocate NorthShore Partnership in Chicago Tribune](https://juniperadvisory.com/juniper-advisory-weighs-in-on-advocate-northshore-partnership-in-chicago-tribune/) - Juniper Advisory's Jordan Shields was quoted in the Chicago Tribune article "Advocate Health Care and NorthShore to merge," which announced the systems' plans to consolidate and create a new 16-hospital, $6.8 billion revenue system. The combined system will be known as Advocate NorthShore Health Partners and will rank as the largest system in Illinois and
- [James Burgdorfer Presents Session for The Governance Institute's Leadership Conferences](https://juniperadvisory.com/james-burgdorfer-presents-session-for-the-governance-institutes-leadership-conferences/) - Jamie Burgdorfer is presenting his session titled "Assessing Independence" for The Governance Institute's Leadership Conferences, an educational program provided for health system board members, executives, and physicians. Jamie's talk is being given at the September session in Colorado Springs, CO, and the October session in White Sulphur Springs, WV. Jamie is a member of The
- [The Rise of the Hospital Joint Venture](https://juniperadvisory.com/the-rise-of-the-hospital-joint-venture/) - Since the enactment of the Affordable Care Act in 2010, more and more hospitals and health systems have entered into some sort of affiliation, whether through acquisition, membership substitution, joint venture, or clinical affiliation. This trend is a result of the mounting pressures hospitals and health systems face in the current healthcare environment. Yet, fundamental
- [Juniper Advisory Comments on West Pennsylvania Jameson Health Merger in Modern Healthcare](https://juniperadvisory.com/juniper-advisory-comments-on-west-pennsylvania-jameson-health-merger-in-modern-healthcare/) - Juniper Advisory's Rex Burgdorfer was quoted in the Modern Healthcare article "UPMC strengthening presence north of Pittsburgh with Jameson merger." The article covered the signing of a letter of intent by Pittsburgh-based UPMC to acquire Jameson Health System, a 218-bed, two-campus hospital system based in New Castle, PA, 75 miles north of Pittsburgh. The acquisition
- [Jordan Shields Presents at 9th Annual Healthcare Provider Conference](https://juniperadvisory.com/jordan-shields-presents-at-9th-annual-healthcare-provider-conference/) - Juniper Advisory's Jordan Shields co-presented "Hot and Cold Areas for Healthcare Investment" for the 9th Annual Healthcare Provider Conference, held in Charlotte, NC. The conference was co-sponsored by McGuireWoods, Grant Thornton, Aon, and the American College of Healthcare Executives. The program brings together healthcare executives, providers, lenders, and investors from a variety of industry niches,
- [Watertown Regional Medical Center to Form Joint Venture with LifePoint Hospitals](https://juniperadvisory.com/watertown-regional-medical-center-to-form-joint-venture-with-lifepoint-hospitals/) - Watertown Regional Medical Center (WRMC), a 95-bed independent nonprofit hospital located in Watertown, WI, has selected LifePoint Hospitals to form a joint venture partnership. The two parties have entered a phase of exclusive negotiations toward the development of a letter of intent, which is expected to be completed in the next several weeks. As part
- [Pennock Health Services to Join Spectrum Health](https://juniperadvisory.com/pennock-health-services-to-join-spectrum-health/) - Pennock Health Services (PHS), a nonprofit hospital system located in Hastings, MI, has signed a letter of intent to join Spectrum Health, an 11-hospital west Michigan nonprofit system based in Grand Rapids. The Board of Trustees of PHS unanimously agreed to join Spectrum after executing a controlled competitive process which involved the evaluation of potential
- [Jordan Shields Presents at HFMA First Illinois Chapter's 2014 Fall Summit](https://juniperadvisory.com/jordan-shields-presents-at-hfma-first-illinois-chapters-2014-fall-summit/) - Juniper Advisory's Jordan Shields co-presented "Credit Considerations for Mergers and Acquisitions" at the HFMA First Illinois Chapter's 2014 Fall Summit in Itasca, IL. Jordan was joined by Emily Wadhwani of Fitch Ratings. Jordan and Emily looked at the drivers behind the current wave of hospital consolidation, presented various transaction structures, and explained the implications of
- [New Frontiers in Hospital Joint Ventures](https://juniperadvisory.com/new-frontiers-in-hospital-joint-ventures/) - This article is the second in a series examining the uses of joint ventures, the process of developing a joint venture, and expected trends related to these transactions. In our first article, we examined the history of joint ventures (JVs) and summarized some of the potential benefits to a non-profit hospital or health system considering
- [Mercy Memorial Hospital System Joins ProMedica](https://juniperadvisory.com/mercy-memorial-hospital-system-joins-promedica/) - Mercy Memorial Hospital System (MMHS), a 238-bed nonprofit hospital company located in Monroe, MI, has joined ProMedica, a 13-hospital interstate system based in Toledo, OH. The Board of Trustees of MMHS made the unanimous decision to join ProMedica after a rigorous assessment of strategic alternatives. MMHS is now ProMedica’s third hospital in Michigan. Juniper’s Role
- [Assessing Independence](https://juniperadvisory.com/assessing-independence/) - Several recent surveys indicate that nearly 80 percent of non-profit hospital boards are assessing their independence. This means they are determining whether to affiliate, combine, or remain independent. Only 15 percent of boards were considering this a few years ago. This is the Affordable Care Act’s (ACA) greatest impact on non-profit hospital boardrooms today, and
- [Juniper Advisory's Garden City Hospital Transaction Named Best Deal Under $100 Million Finalist By Crain's Detroit Business](https://juniperadvisory.com/juniper-advisorys-garden-city-hospital-transaction-named-best-deal-under-100-million-finalist-by-crains-detroit-business/) - Garden City Hospital's partnership with Prime Healthcare Services was named the Best Deal Under $100 Million Finalist by Crain's Detroit Business as part of the 2015 Crain's M&A Awards. Juniper's work with Garden City Hospital represented an exceptional outcome for a community that was facing the potential loss of its hospital. Click here for more
- [Platte Valley Medical Center to Merge with SCL Health](https://juniperadvisory.com/platte-valley-medical-center-to-merge-with-scl-health/) - Platte Valley Medical Center (PVMC) in Brighton, CO has signed a letter of intent to merge with SCL Health in Denver. The transaction is notable, in large part, due to PVMC’s highly proactive consideration of strategic alternatives. The Company enjoys very strong financial characteristics and a modern hospital campus. Despite these attributes, its Board felt
- [Continuing a Non-Profit Hospital's Charitable Mission through Mergers and Acquisitions](https://juniperadvisory.com/continuing-a-non-profit-hospitals-charitable-mission-through-mergers-and-acquisitions/) - Business combinations between acute care non-profit hospital companies continue at a pace not seen since the 1990s. Participants are proactively entering the market for corporate control in an effort to forge partnerships that will position them to be successful in the future era of healthcare delivery. This is not just a response to “Obamacare” or
- [Rex Burgdorfer Discusses the Rise of Hospital Joint Ventures with Waller](https://juniperadvisory.com/rex-burgdorfer-discusses-the-rise-of-hospital-joint-ventures-with-waller/) - Rex Burgdorfer was interviewed by Waller's Ken Marlow in a feature titled "The Rise of Hospital Joint Ventures." Ken and Rex discussed recent events and trends affecting hospital M&A activity, the challenges faced by health systems as a result of these trends, and the unique solutions that joint ventures can offer to hospitals as they
- [James Burgdorfer Presents at the University of Texas School of Law's Health Law Conference](https://juniperadvisory.com/james-burgdorfer-presents-at-the-university-of-texas-school-of-laws-health-law-conference/) - James Burgdorfer co-presented "Healthcare M&A -- Trends and Considerations" for the University of Texas School of Law's 27th Annual Health Law Conference in Houston, TX. Jamie was joined by Lisa Genecov, Partner at Norton Rose Fulbright, Jon Harris, Partner at King & Spalding, and Gary Ruff, Senior Vice President at Tenet Healthcare, where they need
- [Pennock Healthcare System Joins Spectrum Health](https://juniperadvisory.com/pennock-healthcare-system-joins-spectrum-health/) - Pennock Healthcare System (PHS), a nonprofit hospital system located in Hastings, MI, has joined Spectrum Health, a 12-hospital west Michigan nonprofit system based in Grand Rapids. The Board of Trustees of PHS unanimously agreed to join Spectrum after executing a controlled competitive process which involved consideration of potential partners from around the country. The selection
- [Building a Hospital Joint Venture: A Blueprint for Success](https://juniperadvisory.com/building-a-hospital-joint-venture-a-blueprint-for-success/) - This is the third and final article in a series examining the uses of health system joint ventures, the process of developing a joint venture, and expected trends related to these transactions. In the first two articles, we looked back into the history of joint ventures (JVs), the factors leading to their emergence, and the
- [KishHealth System Signs Letter of Intent with Northwestern Memorial HealthCare](https://juniperadvisory.com/kishhealth-system-signs-letter-of-intent-with-northwestern-memorial-healthcare/) - KishHealth System (KHS), a two-hospital integrated nonprofit health system based in DeKalb, IL, has signed a Letter of Intent to explore an affiliation with Northwestern Memorial HealthCare (NMHC). The Boards of KHS and NMHC elected to enter a diligence phase, which, if completed to the satisfaction of both parties, would culminate in KishHealth becoming the
- [Adventist Health Grows with Acquisition of Lodi Health](https://juniperadvisory.com/adventist-health-grows-with-acquisition-of-lodi-health/) - Adventist Health, a multi-state nonprofit health system based in Roseville, CA, has acquired Lodi Health, a fully-integrated community health system based in Lodi, CA. Adventist was chosen unanimously by the Lodi Board of Directors after a competitive process which included other major regional nonprofit systems. Adventist was selected due to its unique blend of culture
- [Rex Burgdorfer Delivers Keynote at Central Penn Business Journal's Healthcare Symposium 2015](https://juniperadvisory.com/rex-burgdorfer-delivers-keynote-at-central-penn-business-journals-healthcare-symposium-2015/) - Rex Burgdorfer was the keynote speaker for Central Penn Business Journal's Healthcare Symposium 2015, which was held in Harrisburg, PA. Rex's keynote covered current trends in hospital mergers and acquisitions, including the reasons why health systems are merging and how new partnership models are changing the hospital industry's structure. In addition to covering hospital M&A,
- [New Partnership to Strengthen Health Care in Nebraska](https://juniperadvisory.com/new-partnership-to-strengthen-health-care-in-nebraska/) - The Dodge County (Neb.) Board of Supervisors, Fremont Health Board of Trustees and Nebraska Methodist Health System Board of Directors approved a strategic partnership between Fremont Health and Methodist. “[fusion_builder_container hundred_percent="yes" overflow="visible"][fusion_builder_row][fusion_builder_column type="1_1" background_position="left top" background_color=" border_size=" border_color=" border_style="solid" spacing="yes" background_image=" background_repeat="no-repeat" padding=" margin_top="0px" margin_bottom="0px" class=" id=" animation_type=" animation_speed="0.3" animation_direction="left" hide_on_mobile="no" center_content="no" min_height="none"][Fremont Health is]
- [Good Shepherd Health System Begins Strategic Partnership Search](https://juniperadvisory.com/good-shepherd-health-system-begins-strategic-partnership-search/) - Good Shepherd Health System (GSHS), a two-hospital nonprofit community health system based in Longview, TX, has announced its intention to explore a potential strategic partnership. Juniper Advisory will assist the Board of Directors and executive leadership team on a formalized exploration of potential partners and partnership structures so that GSHS may continue to provide high-quality
- [Wisconsin Sees First Nonprofit Hospital Conversion with Joint Venture Between Watertown Regional Medical Center and LifePoint Health](https://juniperadvisory.com/wisconsin-sees-first-nonprofit-hospital-conversion-with-joint-venture-between-watertown-regional-medical-center-and-lifepoint-health/) - Watertown Regional Medical Center (WRMC), an independent nonprofit hospital located in Watertown, WI, has formed a joint venture partnership with LifePoint Health. This represents the first conversion of a nonprofit hospital in the state of Wisconsin. The unique structure allows WRMC to retain significant control over parent company-level decisions via a 50% blocking interest on
- [Platte Valley Medical Center Joins SCL Health](https://juniperadvisory.com/platte-valley-medical-center-joins-scl-health/) - Platte Valley Medical Center (PVMC) in Brighton, CO has joined SCL Health in Denver. This transaction is notable, in large part, due to PVMC’s highly proactive consideration of strategic alternatives. PVMC enjoys very strong financial characteristics and a modern hospital campus. Nevertheless, the Board felt that an objective assessment of PVMC’s ability to remain independent
- [Aria Health to Join Jefferson](https://juniperadvisory.com/aria-health-to-join-jefferson/) - Aria Health, a three-hospital integrated health system in northeast Philadelphia and Lower Bucks County, has signed a letter of intent to join Jefferson Health, the rapidly-growing health system formed by the merger of Abington and Jefferson in May 2015. The Aria and Jefferson boards both voted unanimously to authorize the signing of the LOI. Jefferson
- [Alpena Regional Medical Center to Join MidMichigan, a University of Michigan Health System Affiliate](https://juniperadvisory.com/alpena-regional-medical-center-to-join-midmichigan-a-university-of-michigan-health-system-affiliate/) - Alpena Regional Medical Center (ARMC), a county-owned health system in northeast Michigan, has signed a letter of intent to join MidMichigan Health, a four-hospital regional nonprofit health system affiliated with the University of Michigan Health System. As part of MidMichigan, and with the University of Michigan affiliation, ARMC will receive improved access to financial and
- [Barry Sagraves Moderates Panel for Hospital 100 Leadership & Strategy Conference](https://juniperadvisory.com/barry-sagraves-moderates-panel-for-hospital-100-leadership-strategy-conference/) - Barry Sagraves moderated the panel "Finding the Formula to Turn 'Pay for Performance' into 'Profit'" for the Hospital 100 Leadership & Strategy Conference, held in Key Biscayne, FL. Barry's panel included Linda Hoff, CFO of Legacy Health, Vince Pryor, EVP and CFO of Edward-Elmhurst Healthcare, and Doug Smith, CFO and Compliance Officer of Intermountain Healthcare.
- [Juniper Advisory and Edelman Present “Evolving Healthcare: Current Trends in Health System Partnerships”](https://juniperadvisory.com/juniper-advisory-and-edelman-present-evolving-healthcare-current-trends-in-health-system-partnerships/) - Current trends in health system partnerships and other provider-side ventures taking place in today’s rapidly evolving healthcare landscape were the key topics of a panel discussion hosted by Edelman and Juniper Advisory at the Edelman office in Washington, D.C. The salon was moderated by Juniper's Jordan Shields, who was joined by a panel including: E.W. Tibbs,
- [3 Compensation Structures for a More Successful Transaction](https://juniperadvisory.com/3-compensation-structures-for-a-more-successful-transaction/) - Eighty-seven percent of hospitals are considering alignment with another hospital or system as a part of their overall strategic planning, according to Dixon Hughes Goodman. This interest is primarily attributed to structural factors in the industry, including the shifting reimbursement environment and issues related to new healthcare regulations that place independent hospitals at a competitive
- [Elliot Health System Considers Strategic Options](https://juniperadvisory.com/elliot-health-system-considers-strategic-options/) - Elliot Health System (EHS), an integrated nonprofit health system and the largest provider of comprehensive healthcare services in southern New Hampshire, has announced the beginning of a process to explore whether a partner could help the system to provide even better, cost-effective care to the communities that it serves. Juniper Advisory is assisting the Board
- [Jordan Shields Presents at Becker's Hospital Review's 4th Annual CEO Roundtable](https://juniperadvisory.com/jordan-shields-presents-at-beckers-hospital-reviews-4th-annual-ceo-roundtable/) - Jordan Shields presented "Regional Strategies and Affiliation Considerations for Community Hospitals" at Becker's Hospital Review's 4th Annual CEO Roundtable in Chicago, IL. Jordan was joined on the panel by Bill Sexton, CEO of Crossing Rivers Health, and Michael Williams, President and CEO of Community Hospital Corporation. The discussion was moderated by Geoffrey Cockrell, Partner at
- [KishHealth System Joins Northwestern Memorial HealthCare](https://juniperadvisory.com/kishhealth-system-joins-northwestern-memorial-healthcare/) - KishHealth System (KHS), a two-hospital integrated nonprofit health system based in DeKalb, IL, has joined Northwestern Memorial HealthCare (NMHC). The geographic footprint of NMHC dramatically expands with the addition of KHS and grows NMHC beyond Chicago’s western suburbs into rural communities. The consummation of the partnership follows a rigorous exploration by the KHS Board of
- [2015: Celebrating Our Clients' Success](https://juniperadvisory.com/2015-celebrating-our-clients-success/) - With the end of the year approaching, we wanted to take a moment to reflect on our clients’ many successes during 2015. Juniper has been fortunate to advise 20 hospitals and health systems on a variety of partnerships this year, representing hundreds of millions of dollars of new investment and the retention of important jobs
- [The Hospital Joint Venture Handbook](https://juniperadvisory.com/the-hospital-joint-venture-handbook/) - This joint venture handbook is based upon a series of articles that we began writing for The Governance Institute in the summer of 2014. One year later, many of the “new frontiers” in hos­pital joint ventures that we outlined have continued to evolve at a rapid rate, and new forms of creative partnerships are announced
- [Affiliations: Matching Objectives and Risks](https://juniperadvisory.com/affiliations-matching-objectives-and-risks/) - Affiliations are contractual arrangements between two or more hospital partners in which they agree to work together on projects. No ownership or control is exchanged in affiliations; however, the term is sometimes used euphemistically, or incorrectly, to describe business combinations. These sorts of agreements have existed for many decades as non-profit hospitals have pursued contractual
- [Responding to the HIT Imperative: A Guide for Independent Hospitals](https://juniperadvisory.com/responding-to-the-hit-imperative-a-guide-for-independent-hospitals/) - Independent hospitals and small health systems face a daunting challenge in developing their healthcare IT capabilities to meet the requirements of value-based care. But they must carefully weigh their options and proceed cautiously in meeting that challenge. Health systems that lack the financial wherewithal to develop an electronic health record system on their own, and
- [Community Health Center of Branch County Enters Into Innovative Partnership with ProMedica](https://juniperadvisory.com/community-health-center-of-branch-county-enters-into-innovative-partnership-with-promedica/) - Community Health Center of Branch County (CHC), a nonprofit county-owned hospital in Coldwater, MI, has entered into an innovative partnership with ProMedica, a 13-hospital integrated nonprofit health system based in Toledo, OH, to protect and expand healthcare services in south-central Michigan. As part of the partnership, ProMedica is now managing the hospital and has further
- [Central Iowa Healthcare Launches Strategic Options Process](https://juniperadvisory.com/central-iowa-healthcare-launches-strategic-options-process/) - The Board of Trustees of Central Iowa Healthcare (CIH), a 49-bed nonprofit community hospital in Marshalltown, IA, has initiated a process to explore its strategic partnership options. Juniper Advisory will work with the Board and management team of CIH to conduct a systematic process to consider a variety of potential partners and partnership structures. The
- [What Hospital Leaders Can Learn From 'Downton Abbey'](https://juniperadvisory.com/what-hospital-leaders-can-learn-from-downton-abbey/) - 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 phenomenon is hospital consolidation, and historical period drama "Downton Abbey" tackled it with the same gusto with which it took on the deterioration of class
- [New Legislation Paves Way for Regional Nonprofit Partnership in Michigan](https://juniperadvisory.com/new-legislation-paves-way-for-regional-nonprofit-partnership-in-michigan/) - Alpena Regional Medical Center (ARMC), a county-owned health system in northeast Michigan, has joined MidMichigan Health, a regional nonprofit health system affiliated with the University of Michigan Health System. ARMC will become the second largest medical center in the five-hospital MidMichigan Health system. The transaction is notable, in particular, because state law required that legislation
- [Defending the Deal: AG Review Process in Hospital Conversions](https://juniperadvisory.com/defending-the-deal-ag-review-process-in-hospital-conversions/) - 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 sale, joint venture, or other arrangements. Partnerships between independent nonprofit hospitals and larger health care systems (nonprofit and for-profit) have been growing over the past
- [Do Hospital Affiliations Risk Becoming the Next Brexit?](https://juniperadvisory.com/do-hospital-affiliations-risk-becoming-the-next-brexit/) - 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 independent. The EU member countries gain a measure of collective strength and influence by ceding control over certain decisions, regulations and institutions to a central
- [Aria Health Joins Jefferson](https://juniperadvisory.com/aria-health-joins-jefferson/) - Aria Health, a three-hospital integrated health system in northeast Philadelphia and Lower Bucks County, has joined Jefferson, Philadelphia and southern New Jersey’s rapidly-growing clinical and academic health system. As part of the partnership, Jefferson will invest in information technology, outpatient services, and physician alignment for Aria. Aria will also become a regional referral site and
- [Partnership Road Map: Navigating Health System Integration](https://juniperadvisory.com/partnership-road-map-navigating-health-system-integration/) - 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 and structure all play important roles in determining the ultimate success of an organization and a partnership. In forming a partnership, choices are made (even
- [UChicago Medicine Grows with Ingalls Health System](https://juniperadvisory.com/uchicago-medicine-grows-with-ingalls-health-system/) - The University of Chicago Medicine, one of the nation’s leading academic medical institutions, has acquired Ingalls Health System, an integrated community health system located in Harvey, a south suburb of Chicago. Ingalls will become part of UChicago Medicine’s growing health system. Through the partnership, UChicago Medicine will invest in Ingalls’ network of inpatient and outpatient
- [Barry Sagraves Moderates Panel for 2016 Hospital 100 Leadership & Strategy Conference](https://juniperadvisory.com/barry-sagraves-moderates-panel-for-2016-hospital-100-leadership-strategy-conference/) - Barry Sagraves moderated the panel “Expanding Your Options for Capital Structure” for the 2016 Hospital 100 Leadership & Strategy Conference in Cedar Creek, TX. Barry’s panel included William Fenske, CFO of Rice Memorial Hospital in Willmar, MN, and Doug Smith, CFO of McKay-Dee Hospital in Ogden, UT (a member of the nonprofit Intermountain Healthcare system).
- [Jordan Shields Co-Presents at The Governance Institute's Leadership Conference](https://juniperadvisory.com/jordan-shields-co-presents-at-the-governance-institutes-leadership-conference/) - Jordan Shields co-presented "How to Sell What Works: Collaboration from a Point of Strength & the Impact on Communications" at The Governance Institute's October 2016 Leadership Conference in Nashville, TN. Jordan was joined by Anne Hancock Toomey, Founding Partner of Jarrard Phillips Cate & Hancock. Jordan and Anne discussed the evolution of healthcare mergers and
- [Rex Burgdorfer Co-Presents at IAHA's 2016 Health Law Symposium](https://juniperadvisory.com/rex-burgdorfer-co-presents-at-iahas-2016-health-law-symposium/) - Rex Burgdorfer co-presented "To Merge or Not to Merge: The Top Issues to Consider Before Jumping on the Merger Bandwagon" at the Illinois Association of Healthcare Attorneys' (IAHA) 2016 Annual Health Law Symposium in Chicago, IL. Rex was joined by attorneys Linas Grikis of Polsinelli, Joseph Hylak-Reinholtz of Burke, Warren, MacKay & Serritella, and Brent
- [Change, the One Constant](https://juniperadvisory.com/change-the-one-constant/) - 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 brings more questions that only build upon the uncertainty of the previous news cycle. The delivery of high-quality, efficient, and affordable care in America is
- [In the News: Healthcare executives expect M&A to boost business in 2019](https://juniperadvisory.com/in-the-news-healthcare-executives-expect-ma-to-boost-business-in-2019/) - Healthcare executives expect their businesses to exceed 2018's benchmarks and will largely use mergers and acquisitions to reach those expectations, according to a new survey. Nearly three-quarters of 291 senior executives from pharmaceutical, healthcare IT, medical technology, hospital and health system organizations said they expect better business performance in 2019, according to a new Capital
- [Heritage Valley Health System Expands its Integrated Delivery Network](https://juniperadvisory.com/heritage-valley-health-system-expands-its-integrated-delivery-network/) - Heritage Valley Health System, a two-hospital integrated delivery network in Western Pennsylvania, and Ohio Valley Hospital have completed a strategic business combination. By joining together, the organizations will further enhance their common mission of bringing cost-effective, high-quality care to their respective communities and best meet the health care needs of the region. Heritage Valley Health
- [Regulatory Implications for Change-of-Control](https://juniperadvisory.com/regulatory-implications-for-change-of-control/) - Often, one of the chief terms to be negotiated during a hospital merger is who will govern the hospital post transaction. Will the existing hospital board retain control through an affiliation? Will the acquiring system assume control? Or will a new board be created—and if this is the case, how will it be constituted and
- [Santa Clara County Succeeds in Securing the Future of Endangered Local Hospitals](https://juniperadvisory.com/santa-clara-county-succeeds-in-securing-the-future-of-endangered-local-hospitals/) - The County of Santa Clara (Calif.) assumed responsibility for the operation of O’Connor Hospital in San José, St. Louise Regional Hospital in Gilroy, and De Paul Health Center in Morgan Hill on March 1, 2019. This transaction advances the County Board of Supervisors’ strategic goal to grow the size and scope of the County’s public
- [Government-Affiliated Hospital Business Combinations: The Governance Dynamic](https://juniperadvisory.com/government-affiliated-hospital-business-combinations-the-governance-dynamic/) - Many governmental hospitals might benefit from ownership change; in certain instances it is acutely needed. They face the same pressures to improve quality and lower costs that challenge most hospitals and health systems. In addition, they are confronted with complicated governance structures and disclosure requirements along with restrictions on capital. Leaders of governmental hospitals that
- [The Intersection of Mission and Margin](https://juniperadvisory.com/the-intersection-of-mission-and-margin/) - As healthcare has transformed from a nascent local patchwork of services to one of our country’s leading industries, hospitals hold steadfast to their missions that have roots going back a century or more. The precursors of many public and non-profit hospitals were almshouses or sanitariums created by municipalities or religious orders. These institutions treated the
- [Toxic Individualism and Its Impact on Our Healthcare System](https://juniperadvisory.com/toxic-individualism-and-its-impact-on-our-healthcare-system/) - COVID-19 exposed competing forces within the missions of many standalone hospital systems. These forces include a rugged American individualism on one hand and the desire to efficiently meet the healthcare demands of their communities on the other. Both are valid considerations, but they are often in conflict. By definition, individual entities stand outside the safety
- [Assessing Hospital Preparedness for COVID-19 by Affiliation Status](https://juniperadvisory.com/assessing-hospital-preparedness-for-covid-19-by-affiliation-status/) - Overview System hospitals tend to have more ICU beds, higher case mix indices and are more likely to be a part of physician integration networks compared to like-sized standalone hospitals. These attributes are particularly important findings during the COVID-19 pandemic, where ICU beds are at a premium; experience managing complex cases is essential; and the
- [Evaluating Opportunities for Government-Sponsored Hospitals](https://juniperadvisory.com/evaluating-opportunities-for-government-sponsored-hospitals/) - The COVID-19 pandemic is straining hospital and governmental resources. It is also serving as a catalyst for a major evolution of our nation’s healthcare delivery system, the likes of which we have never before seen. With this confluence of factors, local governments and the hospitals they support are presented with a unique chance to evaluate
- [The Looming Deadline: Repayment of COVID-19 AAP Loans](https://juniperadvisory.com/the-looming-deadline-repayment-of-covid-19-aap-loans/) - CMS’ Accelerated and Advance Payment (AAP) Program has been a lifeline for healthcare providers during the COVID-19 pandemic which loaned hospitals and others $100B. Repayment of these loans begins August 1, 2020 - compounding the financial stress for many hospitals still grappling with the pandemic response. In Waller's latest episode of their podcast PointByPoint, Jordan
- [What if Trader Joe’s Ran Hospitals?](https://juniperadvisory.com/what-if-trader-joes-ran-hospitals-2/) - In 2018, Freakonomics co-author Stephen Dubner posed the question: “Should America be run by Trader Joe’s?” He suggested “the quirky little grocery chain with California roots and German ownership has a lot to teach all of us about choice architecture, efficiency, frugality, collaboration, and team spirit.” Mention efficiency in the context of a health system
- [Scott Becker Interviews Rex Burgdorfer on Private Equity](https://juniperadvisory.com/scott-becker-interviews-rex-burgdorfer-on-private-equity/) - Scott Becker, Partner, McGuireWoods, past Healthcare Department Chair and founder of Becker's Hospital Review, interviews Rex Burgdorfer, Partner, Juniper Advisory, about private equity trends in healthcare. Listen to the full interview here.
- [In the News: State AGs Ramp Up Hospital Transaction Reviews](https://juniperadvisory.com/in-the-news-state-ags-ramp-up-hospital-transaction-reviews/) - Conditions placed on the merger that formed the Boston area’s second-largest health system—Beth Israel Lahey Health—are the latest in a series of strict state oversight actions that will shape large regional health system deals for years to come. State attorneys general have placed stringent conditions on recent transactions that significantly consolidated healthcare services to try
- [Neighboring Hospitals Combine to Enhance Service to Community](https://juniperadvisory.com/neighboring-hospitals-combine-to-enhance-service-to-community/) - On January 1, 2020, Illinois Valley Community Hospital (IVCH) in Peru, IL joined St. Margaret's Health in Spring Valley, IL, a member of SMP Health System. The hospitals, which are located just 4 miles from each other, have both served communities in the Illinois River Valley for more than 100 years. This combination represents a
- [Universities to Merge, Expand Health and Science Education](https://juniperadvisory.com/universities-to-merge-expand-health-and-science-education/) - The University of the Sciences in Philadelphia, the nation’s oldest pharmacy and allied health school, has announced a non-binding Letter of Intent to merge with St. Joseph’s University, a neighboring liberal arts institution. The proposed partnership is unique in the highly-fragmented higher education landscape where affiliations between universities are far less common than in other
- [The Intersection of Mission and Margin in Behavioral Healthcare](https://juniperadvisory.com/the-intersection-of-mission-and-margin-in-behavioral-healthcare/) - As behavioral healthcare has transformed from a nascent local patchwork of services to one of our country’s leading industries, many providers hold steadfast to their missions that have roots going back decades or longer. The precursors of many of today’s healthcare providers were almshouses or sanitariums created by municipalities or religious orders. These institutions treated
- [Hospital Industry Structure: Considering the Impact of the Affordable Care Act](https://juniperadvisory.com/hospital-industry-structure-considering-the-impact-of-the-affordable-care-act/) - 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 (ACA) on hospital consolidation.¹ Leading up to enactment of the ACA, health policy experts had concluded that the U.S. healthcare delivery system was consuming too
- [Membership Substitution Transactions: Why Are They So Misunderstood?](https://juniperadvisory.com/membership-substitution-transactions-why-are-they-so-misunderstood/) - 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 501(c)(3)s have become more acquisitive as a result of economic pressures of the ACA. Nonprofit health systems have been getting much better at participating in
- [Is Healthcare a Charity, Social Service, or Business?](https://juniperadvisory.com/is-healthcare-a-charity-social-service-or-business/) - 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 contend with front-page news, and tweets, daily. Directors are challenged not only by these major economic and political issues but also by the tremendous volume
- [A Year of Change for Community Hospitals](https://juniperadvisory.com/a-year-of-change-for-community-hospitals/) - 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 (M&A) activity, and specifically its impact on independent non-profit hospitals. First, the industry remains among the most fragmented in the U.S. economy. It comprises over
- [Acquisition Currencies in Non-Profit Hospital M&A](https://juniperadvisory.com/acquisition-currencies-in-non-profit-hospital-ma/) - 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 greater attention on the terms, conditions, and value exchanged (financial and otherwise) in business combinations. Regulators are placing a heightened emphasis on “fairness” and “thoroughness”
- [Analysis: Hospitals Buoyed by Tenuous Investment Income](https://juniperadvisory.com/analysis-hospitals-buoyed-by-tenuous-investment-income-2/) - Investment income resulting from a strong stock market has propped up many standalone hospitals’ balance sheets over the past two years, according to a recent evaluation by Juniper Advisory. In analyzing a sample of independent hospitals’ financials, Juniper Advisory found that investment income accounted for nearly half of the hospitals’ net margin. Hospitals that depend
- [Are Hospitals Prepared for a Recession?](https://juniperadvisory.com/are-hospitals-prepared-for-a-recession/) - News coverage of a possible economic recession flared late this summer with a yield curve inversion, a bond market phenomenon that is historically associated with a financial downturn. The curve came with a 3% drop in the Dow and S&P. Healthcare-related stocks took an even larger fall. The Federal Reserve’s interest rate cut failed to
- [COVID-19 Impact on Healthcare M&A](https://juniperadvisory.com/covid-19-impact-on-healthcare-ma/) - The COVID-19 pandemic has upended our nation and our healthcare delivery system. The extreme pressure being put on hospitals during this crisis will permanently change the way healthcare is sought and provided. In addition to the sweeping changes we can expect in clinical standards and care delivery models, we will also see changes in how
- [Provider Realignment Post-Pandemic](https://juniperadvisory.com/provider-realignment-post-pandemic/) - The COVID-19 crisis exposed the high cost of fragmentation within the healthcare industry and will serve as the seminal event that ushers in an era of greater provider integration and concentration. COVID-19 will accelerate U.S. healthcare’s transformation toward a future characterized by the blurring of traditional lines between care delivery and financing. There will be
- [What Happens When CMS Loans Come Due?](https://juniperadvisory.com/what-happens-when-cms-loans-come-due/) - CMS’ Accelerated and Advance Payment (AAP) Program has been a lifeline for healthcare providers during the COVID-19 pandemic. The program, which historically supported hospitals during localized natural disasters, was dramatically expanded at the start of the crisis to offer providers immediate cash infusions. Hospitals could receive six months of Medicare revenue as a loan, with
- [Post-Pandemic Provider Realignment 2.0: If the Past Year Taught Us Anything](https://juniperadvisory.com/post-pandemic-provider-realignment-2-0-if-the-past-year-taught-us-anything/) - By Jordan Shields, Partner, Juniper Advisory, and Brian Fuller, Principal, PYA Calling 2020 a challenging year for the country as a whole and for providers in particular would be a vast understatement. Disruption reigned across global, national, and local industries. The healthcare industry found itself at ground zero of the disruption. Extended elective service moratoria,
- [Ownership Form and Hospital Industry Consolidation](https://juniperadvisory.com/ownership-form-and-hospital-industry-consolidation/) - During the current decade, CEOs of many large non-profit systems have reported that the hospital industry is confronted with major systemic issues that can best be addressed by industry consolidation. These issues center on business complexity and capital demands. They argue that the structure (the number of business entities and their ownership form) of the
- [Whole-Hospital Joint Ventures Between Non-Profit and For-Profit Companies](https://juniperadvisory.com/whole-hospital-joint-ventures-between-non-profit-and-for-profit-companies/) - Boards and managements of non-profit hospital companies are experiencing pressure to consider business combination transactions in light of the need for real consolidation of the industry. A whole-hospital joint venture is an alternative approach to ownership change that falls between the more conventional options available to nonprofits (e.g., combining with a non-profit partner or an
- [Hospital Joint Ventures Between Non-Profit and Investor-Owned Companies](https://juniperadvisory.com/hospital-joint-ventures-between-non-profit-and-investor-owned-companies/) - A joint venture between Duke University Health System and LifePoint Hospitals, Inc., Duke LifePoint, recently completed the acquisition of Marquette General Health System in Marquette, Michigan. This combination represents the most significant use of the rapidly evolving buyer joint venture (BJV) structure. Most investor-owned hospital companies are currently attempting to form similar arrangements with non-profit
- [The Expanding Range of Strategic Alternatives in Hospital System M&A](https://juniperadvisory.com/the-expanding-range-of-strategic-alternatives-in-hospital-system-ma-2/) - Hospital and health system boards are in a difficult position. The business of governing acute care health systems has become increasingly complex in recent years as board governance and industry structure have lagged. The sector has evolved from a strictly charitable function to a major industry that comprises 5 percent of gross domestic product (GDP).
- [The Strategic Alignment Committee](https://juniperadvisory.com/the-strategic-alignment-committee/) - Hospital boards are encouraged to form a “strategic alignment” or similar committee to facilitate the governing board’s ability to evaluate the many business opportunities that will arise for provider organizations in the wake of seismic health reform legislation. The expectation is that the entire spectrum of healthcare organizations— not just hospitals and health systems, but also
- [Community Considerations for Hospital Transactions](https://juniperadvisory.com/community-considerations-for-hospital-transactions/) - When evaluating change-of-control transactions, hospital boards need to be cognizant not only of their fiduciary duties to the corporation, but also of how their decisions will impact the broader community. Selling a hospital, especially to an out-of-town buyer, is a politically charged issue that frequently brings emotional responses from the community. If not handled correctly,
- [The Fiduciary Duties in the "Zone of Insolvency"](https://juniperadvisory.com/the-fiduciary-duties-in-the-zone-of-insolvency/) - Directors of healthcare organizations normally owe fiduciary duties to their shareholders or, in the case of nonprofits, to the charitable mission of the organization. As an organization descends to bankruptcy, however, the board's duties may shift. At some point, the board may be imposed with different and often conflicting obligations to the corporate enterprise as
- [Non-Profit Boards and the Merger Market: Preparation, Organization, and Approach](https://juniperadvisory.com/non-profit-boards-and-the-merger-market-preparation-organization-and-approach/) - This article is Part 2 of our series on the hospital merger market. Part 1 (October, 2007) discussed hospital industry dynamics that have led to many of the change-of-control (“merger market”) transactions in this decade and encouraged non-profit boards to be more proactive in their use of this market. Two Views: For-Profit vs. Non-Profit Few,
- [Why Are So Many Merger Transactions Failing to Close?](https://juniperadvisory.com/why-are-so-many-merger-transactions-failing-to-close/) - During the past year, a startlingly-large number of announced merger agreements were terminated. These transaction failures represent a phenomenon that has great significance for many non-profit boards and managements, however, very little notice has been made of them. This article seeks to explore the reasons for these failures and to suggest certain changes in non-profit
- [Protecting Corporate Value During an Ownership Transition](https://juniperadvisory.com/protecting-corporate-value-during-an-ownership-transition/) - Much has been written about the fiduciary responsibilities of hospital boards that are considering business combinations. Another important issue that has received less attention is leadership continuity throughout the transaction process. Increasingly, there has been harmful senior management and board member turnover during the consideration and pendency of transactions. Hospitals typically have rolling terms for
- [Hospital Consolidation Trends in Today's Healthcare Environment](https://juniperadvisory.com/hospital-consolidation-trends-in-todays-healthcare-environment/) - Economic and health policy experts seem to agree that healthcare delivery is a “market failure.” The U.S. spends much more on healthcare than countries with similar economies—16 percent of the gross domestic product. This puts U.S. businesses at a competitive disadvantage in the global marketplace and acts as a drag on the economy. Despite spending
- [Critical Issues in Hospital and Health System M&A](https://juniperadvisory.com/critical-issues-in-hospital-and-health-system-ma/) - Since the enactment of the Affordable Care Act, the pace of hospital and health system consolidation has accelerated to a level not seen since the late 1990s, when hospitals were reacting to the formation of HMOs. The year 2013 saw a total of 87 consolidation transactions, following 105 in 2012. This volume represents a significant
- [Cover Story M&A: Finding the Right Match](https://juniperadvisory.com/cover-story-ma-finding-the-right-match/) - After years of flat activity, billions of dollars worth of hospital mergers and acquisitions are having a profound effect on the industry. Hospitals of all sizes are being wooed and won as national hospital chains and regional competitors look to grab a bigger share of an increasingly consolidated market or, in some cases, simply to
- [Adventist Announces Behavioral Health Transaction with Acadia](https://juniperadvisory.com/adventist-announces-behavioral-health-transaction-with-acadia-2/) - Adventist Health signed a definitive agreement to sell their behavioral health hospital in Vallejo to Acadia Healthcare (NASDAQ: ACHC) to strengthen behavioral health services in northern California. Juniper proudly advised Adventist on this transaction. The need for comprehensive behavioral health services continues to grow and the provision of care is becoming increasingly complex. As a
- [Our Take: Considering Quality in a Business Combination ](https://juniperadvisory.com/our-take-considering-quality-in-a-business-combination/) - Of the umpteen elements hospital leaders evaluate when considering the viability of a potential partner, quality is generally at the top of the list. A larger partner can bring the scale, resources and expertise many smaller hospitals and systems seek to improve care quality for their community. This can include enhanced clinical protocols and standards, facility
- [Analysis: Hospitals Buoyed by Tenuous Investment Income](https://juniperadvisory.com/analysis-hospitals-buoyed-by-tenuous-investment-income/) - Investment income resulting from a strong stock market has propped up many standalone hospitals’ balance sheets over the past two years, according to a recent evaluation by Juniper Advisory. In analyzing a sample of independent hospitals’ financials, Juniper Advisory found that investment income accounted for nearly half of the hospitals’ net margin. Hospitals that depend
- [IRMC and Cleveland Clinic Finalize Partnership](https://juniperadvisory.com/irmc-and-cleveland-clinic-finalize-partnership/) - The intensive 18-month effort to secure Indian River Medical Center’s future neared its conclusion on October 3, 2018 as the IRMC Board of Directors and the Indian River County Hospital District Trustees voted to approve a series of agreements that will result in IRMC joining the Cleveland Clinical Studies system. Juniper Advisory is serving as
- [Good Shepherd Health System in East Texas Joins CHRISTUS Health](https://juniperadvisory.com/good-shepherd-health-system-in-east-texas-joins-christus-health/) - Good Shepherd Health System (GSHS), a two-hospital nonprofit health system based in Longview, TX, has joined CHRISTUS Health, a Catholic nonprofit health system headquartered in Dallas. GSHS will become an important center for care delivery in CHRISTUS’s rapidly-growing East Texas region. A notable feature of the transaction is that CHRISTUS will assume GSHS’s lease with
- [University Health Care System Acquires Trinity Hospital of Augusta](https://juniperadvisory.com/university-health-care-system-acquires-trinity-hospital-of-augusta/) - University Health Care System (UHCS), an integrated nonprofit health system based in Augusta, GA, has acquired Trinity Hospital of Augusta (Trinity) from Quorum Health Corporation, a for-profit system headquartered in Brentwood, TN. The integration of Trinity will allow UHCS to strengthen its delivery of high-quality and efficient care throughout greater Augusta and neighboring communities in
- [Cleveland Clinic Selected as Hospital Partner of Choice in Vero Beach, Florida](https://juniperadvisory.com/cleveland-clinic-selected-as-hospital-partner-of-choice-in-vero-beach-florida/) - Members of the Indian River Medical Center (IRMC) Board of Directors and the Indian River County Hospital District (IRCHD) have selected Cleveland Clinic as their partner to fuel future growth and the continued delivery of quality healthcare services by IRMC. This decision was reached after a partnership process that involved careful consideration by both the
- [In the News: Temple hires Juniper as it explores possible sale](https://juniperadvisory.com/in-the-news-temple-hires-juniper-as-it-explores-possible-sale/) - Temple University announced Monday it has retained the services of Juniper Advisory to pursue strategic options for Temple University Health System, which include the possible sale of Fox Chase Cancer Center, neighboring Jeanes Hospital or both. The move comes about a month-and-a-half after Temple's Board of Trustees announced it had authorized a series of steps aimed at strengthening the
- [Join the Cleveland Clinic and IRMC to Discuss Florida Hospital Affiliation](https://juniperadvisory.com/join-the-cleveland-clinic-and-irmc-to-discuss-florida-hospital-affiliation/) - The Indian River Medical Center (IRMC) in Vero Beach, Florida, will join the world-renowned Cleveland Clinic in a business combination expected to close by the end of 2018. Engage with leaders from the Cleveland Clinic and Indian River County Hospital District in discussing the transaction at The Governance Institute’s 2019 Leadership Conferences in Naples, Florida on
- [PA Hospital with Minority Owner Joins New Regional Partner](https://juniperadvisory.com/pa-hospital-with-minority-owner-joins-new-regional-partner/) - The Huntingdon, PA-based J.C. Blair Health System has officially joined Penn Highlands Healthcare, effective June 1. J.C. Blair Memorial Hospital, a 71-bed, non-profit community hospital, is now known as Penn Highlands Huntingdon, making it the fifth hospital in the Penn Highlands Healthcare system. Juniper advised J.C. Blair on the transaction. Juniper designed for J.C. Blair
- [Summa Health would become wholly-owned subsidiary of Beaumont Health](https://juniperadvisory.com/summa-health-would-become-wholly-owned-subsidiary-of-beaumont-health/) - Southfield, Michigan-based Beaumont Health and Akron, Ohio-based Summa Health have signed a Letter of Intent to develop a strategic partnership. The arrangement would strengthen both organizations’ cost-effective approaches to partnering with communities in new ways to improve quality of care and overall health. Juniper is advising Beaumont on this transaction. The Letter of Intent signals the beginning
- [Adventist Announces Behavioral Health Transaction with Acadia](https://juniperadvisory.com/adventist-announces-behavioral-health-transaction-with-acadia/) - Adventist Health signed a definitive agreement to sell their behavioral health hospital in Vallejo to Acadia Healthcare (NASDAQ: ACHC) to strengthen behavioral health services in Solano County and the northern California region. Juniper proudly advised Adventist on this transaction. Health systems are continually exploring new ways to deliver better healthcare. When it comes to some
- [What Will a Biden Presidency Mean for U.S. Healthcare?](https://juniperadvisory.com/what-will-a-biden-presidency-mean-for-u-s-healthcare/) - Key Takeaways A split Senate limits legislation to what can pass through budget reconciliation and gain support of all 50 Democrats Anticipate Biden to expand Obamacare and Medicare instead of introducing new programs, like a “public option” The selections of Harris for VP and Becerra for HHS Secretary signal continued tight anti-trust enforcement Expect increased and
- [Scott Becker Interviews Rex Burgdorfer on Investment Banking](https://juniperadvisory.com/scott-becker-interviews-rex-burgdorfer-on-investment-banking/) - Scott Becker, Partner at McGuireWoods, past Healthcare Department Chair and founder of Becker's Hospital Review, interviews Rex Burgdorfer, Managing Director of Juniper Advisory, about how Juniper leverages its investment banking expertise to help nonprofit hospitals assess and develop new business combinations. Listen to the full interview here.
- [Demonstrating Fairness in a Market Approach to Hospital M&A](https://juniperadvisory.com/demonstrating-fairness-in-a-market-approach-to-hospital-ma/) - Last year, we noted that the majority of hospitals and health systems are exploring their options when it comes to potential partnerships. We are starting to see more multi-state transactions that join non-profit health systems across state borders. This comes as organizations look to achieve the scale and geographic reach necessary to make a meaningful
- [Our Take: A Case Study of Rural Success](https://juniperadvisory.com/our-take-a-case-study-of-rural-success/) - Rural providers have been somewhat insulated by the transformation in the health care market over the past decade. Caught between understanding and implementing population health strategies, they are still heavily reliant on fee-for-service reimbursement models versus value-based care. Rural hospitals are fighting for their margins, with few resources available to pilot innovative care strategies or
- [Valuing the Troubled Hospital](https://juniperadvisory.com/valuing-the-troubled-hospital/) - Financial difficulties are commonly the catalyst for hospitals to begin exploring partnership options. As Rex Burgdorfer, Juniper Advisory Vice President, outlines in his latest article "Valuing the Troubled Hospital", court-led restructuring is an option often considered by those with liquidity constraints and significant financial liabilities. For hospitals nearing the zone of insolvency, retiring funded debt,
- [Multi-State Health Systems: On Their Way at Last](https://juniperadvisory.com/multi-state-health-systems-on-their-way-at-last/) - 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 completed combination of Advocate Health Care of Chicago and Aurora Health Care of Milwaukee is an example of this kind of transaction cross-border combination. Most
- [Juniper on Speaking Faculty at Healthcare Law Conference](https://juniperadvisory.com/juniper-on-speaking-faculty-at-healthcare-law-conference/) - Juniper VP Rex Burgdorfer presented at the 2018 Healthcare Law and Compliance Institute annual event at The Fairmont Hotel in Dallas, TX. Rex presented "Managing M&A in an Increasingly Competitive and Transparent Marketplace." Other speaking faculty included representatives from The Cleveland Clinic, Stanford Health Care, Intermountain Healthcare, Ropes & Gray, Skadden, Dell School of Medicine UT Austin, Katten
- [How Good Shepherd Health System Jumped Four Moody's Ratings](https://juniperadvisory.com/how-good-shepherd-health-system-jumped-four-moodys-ratings/) - Good Shepherd Health System (GSHS), which operates two acute care hospitals, trauma centers, a joint venture home health agency, as well as other ancillary medical services, saw its Moody's ratings improve by four levels. Moody’s raised the Longview, Texas–based system’s rating from Caa1, the highest Caa level, to Ba3, the lowest Ba level. If an
- [Barry Sagraves Interviewed for McDermott Will & Emery's Governing Health Podcast Series](https://juniperadvisory.com/barry-sagraves-interviewed-for-mcdermott-will-emerys-governing-health-podcast-series/) - Juniper Advisory's Barry Sagraves was interviewed for Governing Health, a monthly podcast series hosted by the law firm McDermott Will & Emery. Barry, in conversation with McDermott Will & Emery partner Michael Peregrine, presented "Board Oversight of Health Care M&A." The podcast, a resource for hospital and health system board members, explored the latest trends
- [Health System M&A Outlook: Juniper Advisory and Jarrard Interviewed Ahead of Becker's Hospital Review's Annual Meeting](https://juniperadvisory.com/health-system-ma-outlook-juniper-advisory-and-jarrard-interviewed-ahead-of-beckers-hospital-reviews-annual-meeting/) - Juniper Advisory's Rex Burgdorfer and Jarrard's Anne Hancock Toomey were interviewed ahead of their panel for the 8th Annual Becker's Hospital Review Meeting. The session, titled "The Mergers and Acquisitions Market: Assessing Deals and Whether or Not to Merge, Sell or Align," also included insights from attorneys Jeff Peterson and Geoff Cockrell of the law
- [Central Iowa Healthcare Restructures and Joins UnityPoint Health](https://juniperadvisory.com/central-iowa-healthcare-restructures-and-joins-unitypoint-health/) - Juniper Advisory was engaged by the Board of Central Iowa Healthcare (CIH), an acute care nonprofit hospital in Marshalltown, IA, and the Creditors' Committee to assist leadership in the assessment of partnership opportunities. Following a period of financial distress, including worsened leverage, liquidity, profitability, and collections, Juniper led the debtor in possession through a sale
- [Rex Burgdorfer Moderates Panel for Healthcare and Life Sciences Private Equity and Finance Conference](https://juniperadvisory.com/rex-burgdorfer-moderates-panel-for-healthcare-and-life-sciences-private-equity-and-finance-conference/) - Rex Burgdorfer served as the moderator for "Private Equity Investments in the Hospital Sector," a panel at the 14th Annual Healthcare and Life Sciences Private Equity and Finance Conference, presented by McGuireWoods and RSM. Panel participants included Sam Hutcheson, Vice President for Strategic Growth and Development for LifePoint Health, David Jarrard, President & CEO of
- [National Healthcare CXO Summit](https://juniperadvisory.com/national-healthcare-cxo-summit/) - Juniper's James Burgdorfer and Jordan Shields offered a master class titled "Hospital Consolidation Trends - Considering the Role of Industry Structure" at the National Healthcare CXO Summit in Long Beach, CA. The conference was sponsored by Marcus Evans Summits and took place October 20-22, 2013. Click here to read an interview titled "What Hospitals Should
- [Community Hospital 100 Leadership & Strategy Conference](https://juniperadvisory.com/community-hospital-100-leadership-strategy-conference/) - Juniper's Barry Sagraves and David Gordon moderated a session titled "M&A in 2014: Should Community-Based Hospitals be Buying, Selling or Sitting Tight?" for the 2013 Community Hospital 100 Leadership & Strategy Conference in Atlanta, GA from October 20-22, 2013. They were joined on the panel by Gary Muller, CEO of Marquette General Health System, and
- [Memorial Medical Center of West Michigan Merges with Spectrum Health System](https://juniperadvisory.com/memorial-medical-center-of-west-michigan-merges-with-spectrum-health-system/) - Memorial Medical Center of West Michigan (MMC), a nonprofit community hospital in Ludington, MI, has merged with Spectrum Health System (Spectrum), based in Grand Rapids, MI. The transaction closed on October 1, 2013. After proactively considering over two-dozen potential suitors and multiple transaction structures, MMC chose to enter into a business combination with Spectrum. As
- [Portage Health Signs Definitive Agreement with LifePoint Hospitals
](https://juniperadvisory.com/portage-health-signs-definitive-agreement-with-lifepoint-hospitals
/) - Portage Health, a stand-alone 501(c)3 hospital in Hancock, MI has signed a definitive agreement to form a whole hospital joint venture with LifePoint Hospitals. This transaction is the first joint venture of its kind in the Midwest. The agreement, valued at over $100 million, will entail $60 million in capital investments and $40 million to
- [Halifax Regional Merges with Sentara Healthcare](https://juniperadvisory.com/halifax-regional-merges-with-sentara-healthcare/) - Juniper Advisory is pleased to announce that Halifax Regional Health System (“HRHS”) has merged with Sentara Healthcare (“Sentara”), Virginia’s leading not-for-profit healthcare system, based in Norfolk, VA. After considering a broad range of potential partners and transaction structures, HRHS chose to enter into a membership substitution transaction with Sentara. The selection of Sentara was based
- [Memorial Medical Center of West Michigan to Combine with Spectrum Health System](https://juniperadvisory.com/memorial-medical-center-of-west-michigan-to-combine-with-spectrum-health-system/) - Memorial Medical Center of West Michigan (MMC), a nonprofit community hospital in Ludington, MI, has signed a letter of intent to partner with Spectrum Health System (Spectrum), based in Grand Rapids, MI. After proactively considering over two-dozen potential suitors and multiple transaction structures, MMC chose to enter into a business combination with Spectrum. MMC was
- [Southwest Healthcare Transactions Conference](https://juniperadvisory.com/southwest-healthcare-transactions-conference/) - Barry Sagraves spoke at the 6th Annual Southwest Healthcare Transactions Conference in Dallas, TX, which was held May 8-9, 2013. Barry served on the panel titled "New School Meets Old School: The Ever Evolving Landscape of Hospital and Health System M&A." The conference brought together healthcare providers and advisors to discuss the latest strategies and
- [Halifax Regional Health System Signs Definitive Agreement to Merge with Sentara Healthcare](https://juniperadvisory.com/halifax-regional-health-system-signs-definitive-agreement-to-merge-with-sentara-healthcare/) - Halifax Regional Health System (HRHS) has signed a definitive agreement to merge with Sentara Healthcare (Sentara), Virginia’s leading nonprofit healthcare system, based in Norfolk, VA. After considering a broad range of potential partners and transaction structures, HRHS chose to enter into a membership substitution transaction with Sentara, given its similar mission rooted in community-based, high-quality
- [Bell Hospital Signs Letter of Intent to be Acquired by LifePoint Hospitals](https://juniperadvisory.com/bell-hospital-signs-letter-of-intent-to-be-acquired-by-lifepoint-hospitals/) - Bell Hospital, a stand-alone 501(c)3 in Ishpeming, Michigan, has signed a letter of intent to be acquired by LifePoint Hospitals. This strategic partnership will ensure the future viability of the hospital and maintain healthcare services in the Ishpeming community. As part of the transaction, Bell will retire all of its financial obligations, fund a charitable
- [Portage Health Signs Letter of Intent to Form Joint Venture with LifePoint Hospitals](https://juniperadvisory.com/portage-health-signs-letter-of-intent-to-form-joint-venture-with-lifepoint-hospitals/) - Portage Health, a stand-alone 501(c)3 hospital in Hancock, Michigan, has signed a letter of intent to form a whole hospital joint venture with LifePoint Hospitals. This transaction, valued at over $100 million, is the first joint venture of its kind in the state of Michigan. It will create one of the largest charitable foundations in
- [Webinar: Non-Profit M&A: Benefits and Pitfalls](https://juniperadvisory.com/webinar-non-profit-ma-benefits-and-pitfalls/) - Analyzing Tax, Accounting and Business Aspects of Partnerships This webinar provided advisors to non-profits with a review of the business and regulatory benefits and risks of a broad variety of mergers and acquisitions, partnerships, and other business ventures among non-profits. Description Non-profit organizations are considering mergers and acquisitions at the highest rate ever, sometimes to
- [Juniper Newsletter: November 2012](https://juniperadvisory.com/juniper-newsletter-november-2012/) - RESEARCH PUBLICATIONS Joint Ventures between Non-Profit and Investor-Owned Hospitals: Uses and Future Applications James Burgdorfer wrote a paper for the Governance Institute exploring the practical features of "buyer joint venture" transactions. This topic was prompted by the most significant use of the rapidly evolving structure, where Juniper advised Marquette General Health System in Michigan on
- [The Impact of Healthcare Reform 
on Hospital Consolidation](https://juniperadvisory.com/the-impact-of-healthcare-reform-
on-hospital-consolidation/) - Juniper Advisory and McGuireWoods presented a webinar titled "The Impact of Healthcare Reform on Hospital Consolidation" on September 16, 2010. Speakers included James E. Burgdorfer, principal of Juniper Advisory; Rex J. Burgdorfer, associate at Juniper Advisory; Thomas C. Brown Jr., a partner at McGuireWoods; Barton C. Walker, an attorney at McGuireWoods and Kristian A. Werling, an
- [Juniper Advisory Breaks Down 5 Most Interesting Hospital Deals of 2014 for Becker's Hospital Review](https://juniperadvisory.com/juniper-advisory-breaks-down-5-most-interesting-hospital-deals-of-2014-for-beckers-hospital-review/)

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## Transactions

- [Sharp HealthCare and Tri-City Healthcare District Complete Strategic Partnership](https://juniperadvisory.com/transactions/sharp-healthcare-and-tri-city-healthcare-district-complete-strategic-partnership/) - Tri-City Medical Center has joined SHARP Healthcare. We advised Tri-City Medical Center on this transaction. READ MORE
- [Freeman Health System Completes Expansion into Northwest Arkansas](https://juniperadvisory.com/transactions/freeman-health-system-completes-expansion-into-northwest-arkansas/) - Northwest Health, a four-hospital subsidiary of Community Health Systems, has joined Freeman Health System. We advised Freeman Health System on this transaction. READ MORE
- [MercyOne a member of Trinity Health divests Siouxland Medical Center to UnityPoint Health](https://juniperadvisory.com/transactions/mercyone-a-member-of-trinity-health-divests-siouxland-medical-center-to-unitypoint-health/) - MercyOne a member of Trinity Health divests Siouxland Medical Center to UnityPoint Health. We advised MercyOne on this transaction.
- [Crestwood Medical Center an affiliate of Community Health Systems has joined Huntsville Hospital Health System](https://juniperadvisory.com/transactions/crestwood-medical-center-has-joined-huntsville-hospital-health-system/) - Crestwood Medical Center an affiliate of Community Health Systems has joined Huntsville Hospital Health System. We advised Huntsville Hospital Health System on this transaction. READ MORE
- [Riverview Health Finalizes Management Agreement with Parkview Health](https://juniperadvisory.com/transactions/riverview-health-finalizes-management-agreement-with-parkview-health/) - Riverview Health and Parkview Health have executed a management services agreement. We advised Riverview Health on this transaction. READ MORE
- [The Bellevue Hospital has joined Firelands Health](https://juniperadvisory.com/transactions/the-bellevue-hospital-has-joined-firelands-health/) - The Bellevue Hospital has joined Firelands Health. We advised The Bellevue Hospital on this transaction. READ MORE
- [Marshfield Clinic Health System joins Sanford Health](https://juniperadvisory.com/transactions/marshfield-clinic-health-system-joins-sanford-health/) - Marshfield Clinic Health System has joined Sanford Health. We advised Marshfield Clinic Health System on this transaction. READ MORE
- [Lawrence General Hospital Expands Community Care with Acquisition of Steward Health Care’s Holy Family Hospitals](https://juniperadvisory.com/transactions/lawrence-general-hospital-expands-community-care-with-acquisition-of-steward-health-cares-holy-family-hospitals/) - Lawrence General Hospital has acquired both Holy Family Hospital campuses in Methuen and Haverhill, MA. These are former facilities of Steward Health Care. We advised Lawrence General Hospital on this transaction. READ MORE
- [Blount Memorial Hospital in Blount County, TN joins Prisma Health](https://juniperadvisory.com/transactions/blount-memorial-hospital-in-blount-county-tn-joins-prisma-health/) - Blount Memorial Hospital in Blount County, TN joins Prisma Health READ MORE
- [Liberty Hospital joins The University of Kansas Health System](https://juniperadvisory.com/transactions/liberty-hospital-joins-the-university-of-kansas-health-system/) - Liberty Hospital has joined The University of Kansas Health System. We advised Liberty Hospital on this transaction. READ MORE
- [Alpena Regional Medical Center has been acquired by MidMichigan Health](https://juniperadvisory.com/transactions/alpena-regional-medical-center-has-been-acquired-by-midmichigan-health/) - Alpena Regional Medical Center has been acquired by MidMichigan Health, a University of Michigan Health System affiliate. We advised Alpena Regional Medical Center on this transaction.
- [Aria Health has joined Thomas Jefferson University](https://juniperadvisory.com/transactions/aria-health-has-been-acquired-by-jefferson/) - Aria Health has joined Thomas Jefferson University. We advised Aria Health on this transaction.
- [Ingalls Health System has joined UChicago Medicine](https://juniperadvisory.com/transactions/ingalls-health-system-has-been-acquired-by-uchicago-medicine/) - Ingalls Health System has joined UChicago Medicine. We advised UChicago Medicine on this transaction.
- [Good Shepherd Health System has joined CHRISTUS Health](https://juniperadvisory.com/transactions/good-shepherd-health-system-has-been-acquired-by-christus-health/) - Good Shepherd Health System has joined CHRISTUS Health. We advised Good Shepherd Health System on this transaction.
- [Trinity Hospital of Augusta has been acquired by University Health Care System](https://juniperadvisory.com/transactions/trinity-hospital-of-augusta-has-been-acquired-by-university-health-care-system/) - Trinity Hospital of Augusta, a subsidiary of Quorum Health, has been acquired by University Health Care System. We advised University Health Care System on this transaction.
- [Ellwood City Hospital has been acquired by Americore Health LLC](https://juniperadvisory.com/transactions/the-ellwood-city-hospital-has-been-acquired-by-americore-health-llc/) - Ellwood City Hospital has been acquired by Americore Health LLC. We advised Ellwood City Hospital on this transaction.
- [Our Lady of Fatima Villa has been acquired by CareTrust REIT and Kalesta Health Care](https://juniperadvisory.com/transactions/our-lady-of-fatima-villa-has-been-acquired-by-caretrust-reit-and-kalesta-health-care/) - Our Lady of Fatima Villa has been acquired by CareTrust REIT which will lease the healthcare facility to affiliates of, Kalesta Healthcare. We advised Our Lady of Fatima Villa on this transaction.
- [LCMC Health has acquired three hospitals from a partnership between HCA and Tulane](https://juniperadvisory.com/transactions/lcmc-health-partners-with-tulane-university-in-new-orleans-la/) - LCMC Health has acquired three hospitals from a partnership between HCA Healthcare and Tulane University. We advised LCMC Health on this transaction.
- [Fremont Health has joined Nebraska Methodist Health System](https://juniperadvisory.com/transactions/fremont-health-has-entered-into-an-affiliation-with-nebraska-methodist-health-system/) - The Dodge County (Neb.) Board of Supervisors, Fremont Health Board of Trustees and Nebraska Methodist Health System Board of Directors approved a strategic partnership between Fremont Health and Methodist. The newly created subsidiary of Methodist, Methodist Fremont Health, will lease Fremont health facilities, including Fremont Health Medical Center, from Dodge County. We advised Fremont Health
- [Indian River Medical Center has joined the Cleveland Clinic](https://juniperadvisory.com/transactions/indian-river-medical-center-has-joined-the-cleveland-clinic/) - Indian River Medical Center has joined the Cleveland Clinic. The Cleveland Clinic has entered into a long-term lease agreement with Indian River County and a membership substitution transaction with Indian River Medical Center. We advised Indian River Medical Center on this transaction.
- [Ohio Valley Hospital has joined Heritage Valley Health System](https://juniperadvisory.com/transactions/ohio-valley-hospital-has-been-acquired-by-heritage-valley-health-system/) - Ohio Valley Hospital has joined Heritage Valley Health System. We advised Heritage Valley Health System on this transaction.
- [Santa Clara County has acquired three facilities from Verity Health](https://juniperadvisory.com/transactions/santa-clara-county-acquired-three-facilities-from-verity-health/) - St. Louise Regional Hospital, O’Connor Hospital and DePaul Health Center joined Santa Clara County’s public healthcare delivery system after Verity Health filed for Chapter 11 protection. We advised Santa Clara County on this transaction.
- [J.C. Blair Health System has joined Penn Highlands Healthcare](https://juniperadvisory.com/transactions/j-c-blair-health-system-has-joined-penn-highlands-healthcare/) - The Huntingdon, PA-based J.C. Blair Health System has officially joined Penn Highlands Healthcare. J.C. Blair Memorial Hospital, a 71-bed, non-profit community hospital, is now known as Penn Highlands Huntingdon, making it the fifth hospital in the Penn Highlands Healthcare system. We advised J.C. Blair Health System on this transaction.
- [Beaumont Health announced acquisition of Summa Health](https://juniperadvisory.com/transactions/beaumont-health-announced-acquisition-of-summa-health/) - Beaumont Health announced the acquisition of Summa Health but did not close. We advised Beaumont Health on this transaction.
- [Illinois Valley Community Hospital has joined St. Margaret's Health](https://juniperadvisory.com/transactions/illinois-valley-community-hospital-has-joined-st-margarets-health/) - Illinois Valley Community Hospital has joined St. Margaret’s Health, a member of SMP Health System. We advised Illinois Valley on this transaction.
- [Kentucky River Medical Center has been acquired by Quorum Health](https://juniperadvisory.com/transactions/kentucky-river-in-jackson-ky/) - National Health Investors (NYSE: NHI), a publicly traded Real Estate Investment Trust (REIT) has divested Kentucky River Medical Center in Jackson, KY to Quorum Health. This was NHI’s sole acute care hospital, and the transaction reflects a portfolio management strategy to focus on core business operations. We advised National Health Investors, Inc. on this transaction.
- [Monterey County's Natividad Medical Center explores strategic growth opportunities](https://juniperadvisory.com/transactions/monterey-countys-natividad-medical-center-explores-strategic-growth-opportunities/) - Monterey County’s Natividad Medical center explores strategic growth opportunities in an aim to bridge health inequity. We advised both Natividad and the County on this project.
- [Jefferson Health has purchased interest in Health Partners Plan from Temple University](https://juniperadvisory.com/transactions/temple-university-in-philadelphia-pa/) - Temple University in Philadelphia has divested its 50% ownership stake in Health Partners Plans (HPP) to Jefferson Health. HPP is a non-profit hospital-owned Medicare and Medicaid Health Maintenance Organization (HMO) covering 290,000 lives in Eastern-Pennsylvania. The transaction was valued at $305 million. We advised Temple University on this transaction.
- [University of the Sciences has joined St. Joseph's University](https://juniperadvisory.com/transactions/university-of-the-sciences-has-joined-st-josephs-university/) - University of the Sciences in Philadelphia, PA has joined St. Joseph’s University in Philadelphia, PA. We advised University of the Sciences on this transaction.
- [Olathe Health has joined The University of Kansas Health System](https://juniperadvisory.com/transactions/olathe-health-is-now-part-of-the-university-of-kansas-health-system/) - Olathe Health has joined The University of Kansas Health System. We advised Olathe Health on this transaction.
- [Genesis Health System has joined MercyOne](https://juniperadvisory.com/transactions/genesis-health-system-has-joined-mercyone/) - Genesis Health System has joined MercyOne. We advised Genesis Health System on this transaction. READ MORE
- [Mid-Columbia Medical Center has joined Adventist Health](https://juniperadvisory.com/transactions/mid-columbia-medical-center-has-joined-adventist-health/) - Mid-Columbia Medical Center has joined Adventist Health. We advised Mid-Columbia Medical Center on this transaction. READ MORE
- [Gerald Champion Regional Medical Center has joined CHRISTUS Health](https://juniperadvisory.com/transactions/gerald-champion-regional-medical-center-has-joined-christus-health/) - Gerald Champion Regional Medical Center has joined CHRISTUS Health. We advised Gerald Champion Regional Medical Center on this transaction. READ MORE
- [Java Medical Group has acquired Fannin Regional Hospital from Quorum Health](https://juniperadvisory.com/transactions/quorum-health-has-sold-fannin-regional-hospital-to-java-medical-group/) - Java Medical Group has acquired Fannin Regional Hospital from Quorum Health. We advised Quorum Health Corporation on this transaction. READ MORE
- [Affiliates of United Healthcare Partners have combined to form Aspire Health](https://juniperadvisory.com/transactions/affiliates-of-united-healthcare-partners-have-combined-to-form-aspire-health/) - Hills & Dales Healthcare, Marlette Regional Hospital, and Deckerville Community Hospital, affiliates of United Healthcare Partners, have combined to form Aspire Health. We advised on this consolidation transaction. READ MORE
- [Group Health Association has been acquired by Humana](https://juniperadvisory.com/transactions/group-health-association-has-been-acquired-by-humana/) - Group Health Association has been acquired by Humana. Juniper advised Group Health Association on this transaction.
- [The managed care business of Lincoln National has been acquired by TakeCare, Inc.](https://juniperadvisory.com/transactions/the-managed-care-business-of-lincoln-national-has-been-acquired-by-takecare-inc/) - The managed care business of Lincoln National has been acquired by TakeCare, Inc. Juniper advised TakeCare, Inc. on this transaction.
- [Twelve HMO assets of TakeCare, Inc. have been acquired by HealthSource and Principal Healthcare](https://juniperadvisory.com/transactions/twelve-hmo-assets-of-takecare-inc-have-been-acquired-by-healthsource-and-principal-healthcare/) - Twelve Health Management Organization Assets of TakeCare, Inc. has been acquired by HealthSource and Principal Healthcare. Juniper advised TakeCare, Inc. on this transaction.
- [Memorial Hospital has entered into a long-term lease agreement with CHRISTUS Health](https://juniperadvisory.com/transactions/memorial-hospital-has-entered-into-a-long-term-lease-agreement-with-christus-health/) - Memorial Hospital has entered into a long-term lease agreement with Christus Health. Juniper advised the City of Corpus Christi, Texas on this transaction.
- [Mid America Health Care Group has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/mid-america-health-care-group-has-been-acquired-by-hospital-corporation-of-america-hca/) - Mid America Health Care Group has been acquired by HCA. Juniper advised Mid America Health Care Group on this transaction.
- [The Rehabilitation Hospital of HealthSouth has been acquired by Via Christi Health](https://juniperadvisory.com/transactions/the-rehabilitation-hospital-of-healthsouth-has-been-acquired-by-via-christi-health/) - The Rehabilitation Hospital of HealthSouth has been acquired by Via Christi Health (formerly St. Francis Regional Medical Center). Juniper advised St. Francis Regional Medical Center on this transaction.
- [The institutional pharmacy business of Health Quest Group, Inc. has been acquired by Grandcare](https://juniperadvisory.com/transactions/the-institutional-pharmacy-business-of-health-quest-group-inc-has-been-acquired-by-grandcare/) - The institutional pharmacy business of Health Quest Group, Inc. has been acquired by Grandcare. Juniper advised Health Quest Groups, Inc. on this transaction.
- [LaGrange Community Hospital has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/lagrange-community-hospital-has-been-acquired-by-hospital-corporation-of-america-hca/) - LaGrange Community Hospital has been acquired by HCA. Juniper advised LaGrange Community Hospital on this transaction.
- [Evangelical Health Systems and Lutheran General Health System have consolidated to form Advocate Health Care](https://juniperadvisory.com/transactions/evangelical-health-systems-and-lutheran-general-health-system-have-consolidated-to-form-advocate-health-care/) - Evangelical Health Systems and Lutheran General Health System have consolidated to form Advocate Health Care. Juniper advised Evangelical Health in this transaction.
- [Highland Lakes Medical Center has been acquired by Ascension Health](https://juniperadvisory.com/transactions/highland-lakes-medical-center-has-been-acquired-by-ascension-health/) - Highland Lakes Medical Center has been acquired by Ascension Health (Daughters)
- [Bell Hospital has been acquired by LifePoint Hospitals](https://juniperadvisory.com/transactions/bell-hospital-has-been-acquired-by-lifepoint-hospitals/) - Bell Hospital has been acquired by LifePoint Hospitals. We advised Bell Hospital on this transaction.
- [Portage Health has formed a joint venture with LifePoint Hospitals](https://juniperadvisory.com/transactions/portage-health-has-formed-a-joint-venture-with-lifepoint-hospitals/) - Portage Health has formed a joint venture with LifePoint Hospitals. We advised Portage Health on this transaction.
- [Iroquois Memorial Hospital has agreed to be managed by Presence Health](https://juniperadvisory.com/transactions/iroquois-memorial-hospital-has-agreed-to-be-managed-by-presence-health/) - Iroquois Memorial Hospital, along with its associated skilled nursing facility, has agreed to a management agreement with Presence Health. IMH will receive management, physician and information technology support under the arrangement. We advised Iroquois Memorial Hospital on this transaction.
- [Meriter Health Services has been acquired by UnityPoint Health](https://juniperadvisory.com/transactions/meriter-health-services-has-been-acquired-by-unitypoint-health/) - Meriter Health Services has been acquired by UnityPoint Health. We advised UnityPoint Health on this transaction.
- [Port Huron Hospital has joined McLaren Health Care](https://juniperadvisory.com/transactions/port-huron-hospital-has-joined-mclaren-health-care/) - Port Huron Hospital has joined McLaren Health Care. We advised Port Huron Hospital on this transaction.
- [Garden City Hospital has joined Prime Healthcare Services](https://juniperadvisory.com/transactions/garden-city-hospital-has-joined-prime-healthcare-services/) - Garden City Hospital has joined Prime Healthcare Services. We advised Garden City Hospital on this transaction.
- [Conemaugh Health System has been acquired by Duke LifePoint Healthcare](https://juniperadvisory.com/transactions/conemaugh-health-system-has-been-acquired-by-duke-lifepoint-healthcare/) - Conemaugh Health System has been acquired by Duke LifePoint Healthcare. We advised Conemaugh Health System on this transaction.
- [Mercy Memorial Hospital System has been acquired by ProMedica](https://juniperadvisory.com/transactions/mercy-memorial-hospital-system-has-been-acquired-by-promedica/) - Mercy Memorial Hospital System has been acquired by ProMedica. We advised Mercy Memorial Hospital System on this transaction.
- [Lenoir Memorial Hospital has entered into a management agreement with Novant Health](https://juniperadvisory.com/transactions/lenoir-memorial-hospital-has-entered-into-a-management-agreement-with-novant-health/) - Lenoir Memorial Hospital has entered into a management agreement with Novant Health. We advised Lenoir Memorial Hospital on this transaction.
- [Pennock Healthcare System has been acquired by Spectrum Health](https://juniperadvisory.com/transactions/pennock-healthcare-system-has-been-acquired-by-spectrum-health/) - Pennock Healthcare System has been acquired by Spectrum Health. We advised Pennock Healthcare System on this transaction.
- [Lodi Health has been acquired by Adventist Health](https://juniperadvisory.com/transactions/lodi-health-has-been-acquired-by-adventist-health/) - Lodi Health has been acquired by Adventist Health. We advised Adventist Health on this transaction.
- [Watertown Regional Medical Center has formed a joint venture with LifePoint Health](https://juniperadvisory.com/transactions/watertown-regional-medical-center-has-formed-a-joint-venture-with-lifepoint-health/) - Watertown Regional Medical Center has formed a joint venture with LifePoint Health. We advised Watertown Regional Medical Center on this transaction.
- [Platte Valley Medical Center has been acquired by SCL Health](https://juniperadvisory.com/transactions/platte-valley-medical-center-has-been-acquired-by-scl-health/) - Platte Valley Medical Center has been acquired by SCL Health. We advised Platte Valley Medical Center on this transaction.
- [KishHealth System has been acquired by Northwestern Memorial Healthcare](https://juniperadvisory.com/transactions/kishhealth-system-has-been-acquired-by-northwestern-memorial-healthcare/) - KishHealth System has been acquired by Northwestern Memorial HealthCare. We advised KishHealth System on this transaction.
- [Community Health Center of Branch County has entered into a phased merger with ProMedica](https://juniperadvisory.com/transactions/community-health-center-of-branch-county-has-entered-into-a-phased-merger-with-promedica/) - Community Health Center of Branch County has entered into a phased merger with ProMedica. We advised Community Health Center of Branch County on this transaction.
- [Fountain Valley Medical Center has been acquired by Health Quest Group has been acquired by OrNda HealthCorp.](https://juniperadvisory.com/transactions/fountain-valley-medical-center-has-been-acquired-by-health-quest-group-has-been-acquired-by-ornda-healthcorp/) - Fountain Valley Medical Center has been acquired by OrNda. We advised Fountain Valley Medical Center on this transaction.
- [Pueblo Norte Lifecare Center has been acquired by Navajo County, Arizona](https://juniperadvisory.com/transactions/pueblo-norte-lifecare-center-has-been-acquired-by-navajo-county-arizona/) - Pueblo Norte Lifecare Center, a subsidiary of Adventist Health, has been acquired by Navajo County, AZ. We advised Pueblo Norte on this transaction.
- [Uinta Hospital has been acquired by Intermountain Healthcare](https://juniperadvisory.com/transactions/uinta-hospital-has-been-acquired-by-intermountain-healthcare/) - Uinta Hospital has been acquired by Intermountain Healthcare. We advised Uinta Hospital on this transaction.
- [Clearview Hospital has been acquired by the Hospital District of Midland, Texas](https://juniperadvisory.com/transactions/clearview-hospital-has-been-acquired-by-the-hospital-district-of-midland-texas/) - Clearview Hospital, a subsidiary of Banner Health, has been acquired by The Hospital District of Midland, Texas. We advised Banner Health on this transaction.
- [St. Joseph's Hospital has been acquired by St. Anthony's Health Center](https://juniperadvisory.com/transactions/st-josephs-hospital-has-been-acquired-by-st-anthonys-health-center/) - St. Joseph's Hospital has been acquired by Saint Anthony's Health Center. We advised Saint Anthony's Health Center on this transaction.
- [San Clemente Hospital has been acquired by Banner Health](https://juniperadvisory.com/transactions/san-clemente-hospital-has-been-acquired-by-banner-health/) - San Clemente Hospital, a subsidiary of PACE, has been acquired by Banner Health. We Advised Banner Health on this transaction.
- [Pathology Institute has been acquired by Meris Laboratories](https://juniperadvisory.com/transactions/pathology-institute-has-been-acquired-by-meris-laboratories/) - Pathology Institute has been acquired by Meris Laboratories. We advised Pathology Institute on this transaction.
- [St. Margaret's Hospital has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/st-margarets-hospital-has-been-acquired-by-hospital-corporation-of-america-hca/) - St. Margaret's Hospital, a subsidiary of Ascension Health, formerly (Daughters of Charity) has been acquired by Hospital Corporation of America (HCA).
- [Emerald Nursing Home has been acquired by Private Investors](https://juniperadvisory.com/transactions/emerald-nursing-home-has-been-acquired-by-private-investors/) - Emerald Nursing Home, a subsidiary of Adventist Health, has been acquired by Private Investors. We advised Adventist Health on this transaction.
- [Simi Valley Hospital has been acquired by Adventist Health](https://juniperadvisory.com/transactions/simi-valley-hospital-has-been-acquired-by-adventist-health/) - Simi Valley Hospital, a subsidiary of SafeCare, has been acquired by Adventist Health. We advised Adventist Health on this transaction.
- [Michael Reese Hospital has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/michael-reese-hospital-has-been-acquired-by-hospital-corporation-of-america-hca/) - Michael Reese Hospital has been acquired by HCA. We advised Michael Reese Medical Center on this transaction.
- [Michael Reese Health Plan has been acquired by Humana](https://juniperadvisory.com/transactions/michael-reese-health-plan-has-been-acquired-by-humana/) - Michael Reese Health Plan has been acquired by Humana. We advised Michael Reese Health Plan on this transaction.
- [American River Hospital has been acquired by Catholic Healthcare West](https://juniperadvisory.com/transactions/american-river-hospital-has-been-acquired-by-catholic-healthcare-west/) - American River Hospital, a subsidiary of Alta Bates, has been acquired by Catholic Healthcare West. We advised Alta Bates on this transaction.
- [Doctors Hospital of Lodi has been acquired by Physician Investors](https://juniperadvisory.com/transactions/doctors-hospital-of-lodi-has-been-acquired-by-physician-investors/) - Doctors Hospital of Lodi, a subsidiary of Paracelsus Healthcare, has been acquired by Physician Investors. We advised Paracelsus Healthcare Corporation on this transaction.
- [St. John's Hospital has been acquired by Champion Healthcare](https://juniperadvisory.com/transactions/st-johns-hospital-has-been-acquired-by-champion-healthcare/) - St. John's Hospital, a subsidiary of Franciscan Sisters of Little Falls, has been acquired by Champion Healthcare. We advised Franciscan Sisters of Little Falls on this transaction.
- [St. Ansgar Hospital has been acquired by Champion Healthcare](https://juniperadvisory.com/transactions/st-ansgar-hospital-has-been-acquired-by-champion-healthcare/) - St. Ansgar Hospital, a subsidiary of Franciscan Sisters of Little Falls, has been acquired by Champion Healthcare. We advised Franciscan Sisters of Little Falls on this transaction.
- [Hotel Dieu Hospital has been acquired by the State of Louisiana](https://juniperadvisory.com/transactions/hotel-dieu-hospital-has-been-acquired-by-the-state-of-louisiana/) - Hotel Dieu Hospital, a subsidiary of Ascension Health, has been acquired by The State of Louisiana. We advised Ascension Health on this transaction.
- [St. Francis Medical Center has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/st-francis-medical-center-has-been-acquired-by-hospital-corporation-of-america-hca/) - St. Francis Medical Center, a subsidiary of Catholic Health East, has been acquired by HCA. We advised Catholic Health East on this transaction.
- [Brazos River Hospital has been acquired by Ascension Health](https://juniperadvisory.com/transactions/brazos-river-hospital-has-been-acquired-by-ascension-health/) - Brazos River Hospital, a subsidiary of HCA, has been acquired by Ascension Health. We advised Group Health Association in this transaction.
- [St. Joseph Hospital & Health Center has been acquired by Ascension Health](https://juniperadvisory.com/transactions/st-joseph-hospital-health-center-has-been-acquired-by-ascension-health/) - St. Joseph Hospital & Health Center, a subsidiary of Christus Health, has been acquired by Ascension Health. We advised Christus Health on this transaction.
- [Behavioral Health Hospital has been acquired by Via Christi Health](https://juniperadvisory.com/transactions/behavioral-health-institute-has-been-acquired-by-via-christi-health/) - Behavioral Health Hospital, a subsidiary of Charter Medical, has been acquired by Via Christi Health. We advised Via Christi Health on this transaction.
- [San Joaquin Community Hospital has been acquired by Adventist Health](https://juniperadvisory.com/transactions/san-joaquin-community-hospital-has-been-acquired-by-adventist-health/) - San Joaquin Community Hospital has been acquired by Adventist Health. We advised Adventist Health on this transaction.
- [Desert Valley Hospital has been acquired by St. Joseph Health System](https://juniperadvisory.com/transactions/desert-valley-hospital-has-been-acquired-by-st-joseph-health-system/) - Desert Valley Hospital has been acquired by St. Joseph Health System. We advised St. Joseph Health System on this transaction.
- [The three Salt Lake City subsidiaries of Trinity Health have been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/the-three-salt-lake-city-subsidiaries-of-trinity-health-have-been-acquired-by-hospital-corporation-of-america-hca/) - The 3 Salt Lake City subsidiaries of Trinity Health have been acquired by HCA. We advised Trinity Health on this transaction.
- [St. Mary of the Plains Hospital has joined Methodist Medical Center](https://juniperadvisory.com/transactions/st-mary-of-the-plains-hospital-has-joined-methodist-medical-center/) - St. Mary of the Plains Hospital a subsidiary of St. Joseph Health System has joined Methodist Medical Center. We advised St. Joseph Health System on this transaction.
- [Health Directions has been acquired by ZA Consulting](https://juniperadvisory.com/transactions/health-directions-has-been-acquired-by-za-consulting/) - Health Directions, a division of Ingalls Health Systems, has been acquired by ZA Consulting. We advised Ingalls Health Systems on this transaction.
- [St. Joseph Hospital and Health Center has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/st-joseph-hospital-and-health-center-has-been-acquired-by-hospital-corporation-of-america-hca/) - St. Joseph Hospital and Health Center (a subsidiary of Ascension Health - formerly Daughters of Charity) has been acquired by HCA. Juniper advised Ascension Health on this transaction.
- [The City of Austin, Texas has leased Breckenridge Hospital to Ascension Health](https://juniperadvisory.com/transactions/the-city-of-austin-texas-has-leased-breckenridge-hospital-to-ascension-health/) - The City of Austin, Texas has leased Breckenridge Hospital to Ascension Health. Juniper advised the City of Austin, TX on this transaction.
- [Mission Viejo Medical Center has been acquired by St. Joseph Health System](https://juniperadvisory.com/transactions/mission-viejo-medical-center-has-been-acquired-by-st-joseph-health-system/) - Mission Viejo Medical Center has been acquired by St. Joseph Health System. Juniper advised St. Joseph Health System on this transaction.
- [Bee County Regional Medical Center has entered into a long-term lease agreement with CHRISTUS Health](https://juniperadvisory.com/transactions/bee-county-regional-medical-center-has-entered-into-a-long-term-lease-agreement-with-christus-health/) - Bee County Regional Medical Center has entered into a long-term lease agreement with Christus Health (formerly Incarnate Word Health System). Juniper advised Christus Health on this transaction.
- [Carney Hospital has been acquired by Caritas Christi Health Care](https://juniperadvisory.com/transactions/carney-hospital-has-been-acquired-by-caritas-christi-health-care/) - Carney Hospital (a subsidiary of Ascension Health - formerly Daughters of Charity) has been acquired by Caritas Christi Healthcare. Juniper advised Ascension Health on this transaction.
- [Pacifica Hospital has been acquired by Doctors Community Healthcare Corporation](https://juniperadvisory.com/transactions/pacifica-hospital-has-been-acquired-by-doctors-community-healthcare-corporation/) - Pacifica Hospital has been acquired by Doctors Community Healthcare System. Juniper advised Pacifica Physician owners on this transaction.
- [Petaluma Valley Hospital has entered into a long-term lease with St. Joseph Health System](https://juniperadvisory.com/transactions/petaluma-valley-hospital-has-entered-into-a-long-term-lease-with-st-joseph-health-system/) - Petaluma Valley Hospital has entered into a long-term lease with St Joseph Health System
- [Integrated Health Physician Services has been acquired by Ascension Health (Sisters of St. Joseph Carondelet)](https://juniperadvisory.com/transactions/integrated-health-physician-services-has-been-acquired-by-ascension-health-sisters-of-st-joseph-carondelet/) - Integrated Health Physician Services has been acquired by Ascension Health (Carondelet)
- [Phoenix General Hospital has been acquired by John C. Lincoln Health Network](https://juniperadvisory.com/transactions/phoenix-general-hospital-has-been-acquired-by-john-c-lincoln-health-network/) - Phoenix General Hospital has been acquired by John C. Lincoln Health Network
- [Michael Reese Medical Center has been acquired by Doctors Community Healthcare Corporation](https://juniperadvisory.com/transactions/michael-reese-medical-center-has-been-acquired-by-doctors-community-healthcare-corporation/) - Michael Reese Medical Center (a subsidiary of HCA) has been acquired by Doctors Community Healthcare Corp.
- [The eight Los Angeles hospital subsidiaries of Paracelsus Healthcare Corporation have been acquired by Alta Healthcare System](https://juniperadvisory.com/transactions/the-eight-los-angeles-hospital-subsidiaries-of-paracelsus-healthcare-corporation-have-been-acquired-by-alta-healthcare-system/) - The eight Los Angeles Hospital subsidiaries of Paracelsus Healthcare Corporation have been acquired by Alta Healthcare System. Juniper advised Paracelsus on this transaction.
- [Central Valley General Hospital has been acquired by Adventist Health](https://juniperadvisory.com/transactions/central-valley-general-hospital-has-been-acquired-by-adventist-health/) - Central Valley General Hospital has been acquired by Adventist Health
- [Chico Community Hospital has been acquired by Enloe Health System](https://juniperadvisory.com/transactions/chico-community-hospital-has-been-acquired-by-enloe-health-system/)
- [Two Los Angeles Foundation Health hospitals have been acquired by Healthplus Corporation](https://juniperadvisory.com/transactions/two-los-angeles-hospitals-subsidiaries-of-foundation-health-have-been-acquired-by-healthplus-corporation/) - Two Los Angeles Foundation Health hospitals have been acquired by HealthPlus Corporation
- [Lanier Park Hospital has been acquired by Northeast Georgia Health System](https://juniperadvisory.com/transactions/lanier-park-hospital-has-been-acquired-by-northeast-georgia-health-system/)
- [Helena Regional Medical Center has entered into a long-term lease agreement with Community Health Systems (CHS)](https://juniperadvisory.com/transactions/helena-regional-medical-center-has-entered-into-a-long-term-lease-agreement-with-community-health-systems-chs/)
- [Yakima Regional Medical Center & Toppenish Community Hospital have been acquired by Health Management Associates (HMA)](https://juniperadvisory.com/transactions/yakima-regional-medical-center-toppenish-community-hospital-have-been-acquired-by-health-management-associates-hma/)
- [Health Midwest has been acquired by Hospital Corporation of America (HCA)](https://juniperadvisory.com/transactions/health-midwest-has-been-acquired-by-hospital-corporation-of-america-hca/)
- [Family Health Plan has been acquired by Centene Corporation](https://juniperadvisory.com/transactions/family-health-plan-has-been-acquired-by-centene-corporation/)
- [Doctors Hospital of Coral Gables has been acquired by Baptist Health South Florida](https://juniperadvisory.com/transactions/doctors-hospital-of-coral-gables-has-been-acquired-by-baptist-health-south-florida/)
- [Eureka General Hospital has been acquired by St. Joseph Health System](https://juniperadvisory.com/transactions/eureka-general-hospital-has-been-acquired-by-st-joseph-health-system/)
- [NIX Health Care System has been acquired by Merit Health Systems](https://juniperadvisory.com/transactions/nix-health-care-system-has-been-acquired-by-merit-health-systems/)
- [The Village at Victory Lakes has been acquired by Franciscan Sisters of Chicago](https://juniperadvisory.com/transactions/the-village-at-victory-lakes-has-been-acquired-by-franciscan-sisters-of-chicago/)
- [Brim Healthcare has been acquired by an Investor Group](https://juniperadvisory.com/transactions/brim-healthcare-has-been-acquired-by-an-investor-group/)
- [Hillcrest HealthCare System has been acquired by Ardent Health Services](https://juniperadvisory.com/transactions/hillcrest-healthcare-system-has-been-acquired-by-ardent-health-services/)
- [Glades General Hospital has been acquired by the Health Care District of Palm Beach County](https://juniperadvisory.com/transactions/glades-general-hospital-has-been-acquired-by-the-health-care-district-of-palm-beach-county/)
- [Via Christi Health has transferred ownership of St. Rose Hospital to a new nonprofit corporation](https://juniperadvisory.com/transactions/via-christi-health-has-transferred-ownership-of-st-rose-hospital-to-a-new-nonprofit-corporation/) - Via Christi has transferred ownership of St. Rose Hospital to a new non-profit corporation.
- [DeKalb Community Hospital has been acquired by Health Management Associates (HMA)](https://juniperadvisory.com/transactions/dekalb-community-hospital-has-been-acquired-by-health-management-associates-hma/)
- [Ponca City Medical Center has been acquired by Community Health Systems (CHS)](https://juniperadvisory.com/transactions/ponca-city-medical-center-has-been-acquired-by-community-health-systems-chs/)
- [Vista Health System has been acquired by Community Health Systems (CHS)](https://juniperadvisory.com/transactions/vista-health-system-has-been-acquired-by-community-health-systems-chs/)
- [Wyoming Valley Health Care System has been acquired by Community Health Systems (CHS)](https://juniperadvisory.com/transactions/wyoming-valley-health-care-system-has-been-acquired-by-community-health-systems-chs/)
- [St. Clare's Health System has been acquired by Catholic Health Initiatives (CHI)](https://juniperadvisory.com/transactions/st-clares-health-system-has-been-acquired-by-catholic-health-initiatives-chi/)
- [Tyler Memorial Hospital has been acquired by Catholic Health Partners](https://juniperadvisory.com/transactions/tyler-memorial-hospital-has-been-acquired-by-catholic-health-partners/)
- [The Bell Tower Residence has entered into a management agreement with Franciscan Advisory Services](https://juniperadvisory.com/transactions/the-bell-tower-residence-has-entered-into-a-management-agreement-with-franciscan-advisory-services/)
- [West Chester Hospital has been acquired by UC Health](https://juniperadvisory.com/transactions/west-chester-hospital-has-been-acquired-by-uc-health/)
- [Logan County Hospital has been acquired by Mercy Health System](https://juniperadvisory.com/transactions/logan-county-hospital-has-been-acquired-by-mercy-health-system/)
- [Trinity Health has sold a 50% interest in its subsidiary Battle Creek Health System to Bronson Healthcare](https://juniperadvisory.com/transactions/trinity-health-has-sold-a-50-interest-in-its-subsidiary-battle-creek-health-system-to-bronson-healthcare/)
- [Methodist Health Services Corporation has joined Iowa Health System](https://juniperadvisory.com/transactions/methodist-health-services-corporation-has-joined-iowa-health-system/)
- [Marquette General Hospital has been acquired by Duke LifePoint Healthcare](https://juniperadvisory.com/transactions/marquette-general-hospital-has-been-acquired-by-duke-lifepoint-healthcare/)
- [Halifax Regional Health System has merged with Sentara Healthcare](https://juniperadvisory.com/transactions/halifax-regional-health-system-has-merged-with-sentara-healthcare/)
- [Memorial Medical Center of West Michigan has been acquired by Spectrum Health](https://juniperadvisory.com/transactions/memorial-medical-center-of-west-michigan-has-been-acquired-by-spectrum-health/)
- [Lander Valley Nursing Home has been acquired by Private Investors](https://juniperadvisory.com/transactions/lander-valley-nursing-home-has-been-acquired-by-private-investors/) - Lander Valley Nursing Home has been acquired by Private Investors. Juniper advised Lander Valley Nursing Home on this transaction.
- [Preferred Care has been acquired by Anthem](https://juniperadvisory.com/transactions/preferred-care-has-been-acquired-by-anthem/) - Preferred Care has been acquired by Anthem (formerly Blue Cross Blue Shield of Missouri). Juniper advised Preferred Care on this transaction.
- [Marion Memorial Hospital has been acquired by Community Health Systems (CHS)](https://juniperadvisory.com/transactions/marion-memorial-hospital-has-been-acquired-by-community-health-systems-chs/) - Marion Memorial Hospital has been acquired by CHS. Juniper advised The City of Marion on this transaction.
- [The congregate care business of Health Quest Group, Inc. has been acquired by Fountains, Inc.](https://juniperadvisory.com/transactions/the-congregate-care-business-of-health-quest-group-inc-has-been-acquired-by-fountains-inc/) - The congregate care business of Health Quest Group, Inc, has been acquired by Fountains Inc. Juniper Advised Health Quest Group on this transaction.
- [Sierra Medical Clinic has been acquired by Doctors Community Healthcare Corporation](https://juniperadvisory.com/transactions/sierra-medical-clinic-has-been-acquired-by-doctors-community-healthcare-corporation/) - Sierra Medical Clinic has been acquired by Doctor's Community Healthcare Corporation. Juniper advised Sierra Medical Clinic on this transaction.
- [Grant Hospital has been acquired by Edgewater Medical Center](https://juniperadvisory.com/transactions/grant-hospital-has-been-acquired-by-edgewater-medical-center/)
- [Des Moines General Hospital has been acquired by Doctors Community Healthcare Corporation](https://juniperadvisory.com/transactions/des-moines-general-hospital-has-been-acquired-by-doctors-community-healthcare-corporation/)
- [The Ravenswood Pavilion has been acquired by NeuroSource Clinical Solutions](https://juniperadvisory.com/transactions/the-ravenswood-pavilion-has-been-acquired-by-neurosource-clinical-solutions/)
- [The City of Muskogee, Oklahoma has leased Muskogee Regional Medical Center to Capella Healthcare](https://juniperadvisory.com/transactions/the-city-of-muskogee-oklahoma-has-leased-muskogee-regional-medical-center-to-capella-healthcare/)

## Team

- [Rex Burgdorfer](https://juniperadvisory.com/team/rex-burgdorfer/) - Rex Burgdorfer is a Partner at Juniper Advisory with over 20 years of investment banking and strategic financial advisory services experience. He has advised all forms of nonprofit hospital systems on M&A transactions, including academic, community 501(c)3, faith-based, and local government entities. Rex was previously with Morgan Stanley and holds an MBA from the Kellogg
- [Brent McDonald](https://juniperadvisory.com/team/brent-mcdonald/) - Brent McDonald is a Partner at Juniper Advisory with over 25 years of experience leading development, strategy, investment banking and legal teams to accomplish the strategic goals of national, regional, and community-based healthcare organizations. He was previously Head of Healthcare Strategic Advisory at Bank of America Merrill Lynch, with responsibility for all not-for-profit healthcare M&A
- [Adam Davis](https://juniperadvisory.com/team/adam-davis/) - Adam Davis is an Executive Director at Juniper Advisory with over ten years of healthcare finance and advisory experience. At Juniper, he leads and supports a variety of M&A transactions for both not-for-profit and for-profit clients that have a range of strategic needs. He was previously at Fitch Ratings, focusing on health system, hospital and senior
- [Farley Reardon](https://juniperadvisory.com/team/farley-reardon/) - Farley Reardon is a Partner at Juniper Advisory with over 25 years of corporate development and capital markets experience in the healthcare industry. At Juniper, he advises healthcare organizations on strategic growth initiatives, including mergers, acquisitions, joint ventures, and divestitures. Prior to joining Juniper, Farley was Vice President of Strategic Growth and Development at Lifepoint
- [Casey Webb](https://juniperadvisory.com/team/casey-webb/) - Casey Webb is a Partner at Juniper Advisory with more than 15 years of transaction advisory experience within the healthcare industry, focusing primarily on hospital and health system partnerships. Her experience spans the hospital industry, including secular not-for-profit, religious, public, academic, taxable and other specialty hospitals. Casey was previously with Huron Consulting Group, where she
- [Charles Willett](https://juniperadvisory.com/team/charles-willett/) - Charles Willett is an Analyst at Juniper Advisory, where he supports the firm's transactions with a focus on financial analysis and execution. Prior to joining Juniper, he held investment banking positions at Robert W. Baird & Co. and Brown Gibbons Lang & Company, where he supported a range of healthcare M&A transactions. Charles graduated Cum
- [Setina Hinojosa-Hanna](https://juniperadvisory.com/team/setina-hinojosa/) - Setina Hinojosa-Hanna is the Marketing Manager at Juniper Advisory overseeing communications strategies at the firm. She has an extensive background in digital and creative fields specializing in enhancing brand visibility and engagement. Prior to Juniper, Setina worked for Girl Scouts promoting growth, equity, and inclusion. Setina holds a BA in Marketing and Management from Oklahoma
- [Edward Davis](https://juniperadvisory.com/team/edward-davis/) - Edward Davis is Finance Director at Juniper Advisory overseeing its financial and tax affairs since the inception of the firm. Edward was a Certified Public Accountant in one of the “Final Four” U.S. public accounting firms where he was a partner specialized in accounting and tax solutions for mid-sized businesses. He also has extensive industry experience
- [Angela Adams](https://juniperadvisory.com/team/angela-adams/) - Angela Adams is Director of Operations at Juniper Advisory and oversees administration and manages the day-to-day office operational functions of the firm. In this role, she supports Juniper’s hospital clients during all phases of engagements. She oversees logistics and office management for the full team nationwide. Prior to joining Juniper, Angela managed the office operations for
- [Nina Leutz](https://juniperadvisory.com/team/nina-leutz/) - Nina Leutz is an Associate at Juniper Advisory with over four years of healthcare strategy consulting experience working with leading healthcare payers and providers. As an Associate at Juniper Advisory, she supports the firm’s transactions from end to end, including data and financial analysis as well as developing presentation materials. Prior to Juniper, she was a
- [Ansley Geary](https://juniperadvisory.com/team/ansley-murphy/) - Ansley Geary is an Associate at Juniper Advisory with expertise as a CPA in accounting, financial modeling, and transaction analysis. She brings several years of strategic and financial advisory experience, including her time at Ernst & Young, where she supervised audit engagements for multinational public and private companies. At Juniper Advisory, Ansley supports all phases of
- [David Gordon](https://juniperadvisory.com/team/david-gordon/) - Dave Gordon is a Principal at Juniper Advisory and has spent his entire investment banking advisory experience concentrated in the healthcare services industry. Prior to forming Juniper, he co-led the M&A groups of Ponder & Co. and John Nuveen & Co. Previously, he managed the healthcare services group at Piper Jaffray. Dave holds an MBA from
- [James Burgdorfer](https://juniperadvisory.com/team/james-burgdorfer/) - Jamie Burgdorfer is a Principal at Juniper Advisory and has concentrated on domestic and international M&A assignments his entire career. He has further specialized in merger work for the healthcare industry since 1992. Prior to forming Juniper, he co-led the M&A group of John Nuveen & Co. and was a member of Citigroup’s mergers and acquisitions
- [Chris Benson](https://juniperadvisory.com/team/chris-benson/) - Chris Benson is a Managing Director at Juniper Advisory, joining the firm after nearly 25 years at the Mayo Clinic, beginning as an Administrative Fellow and ending as Vice Chair of domestic and international provider relations. This included growing the Mayo Clinic Care Network from inception to over 35 nonprofit health systems in the United States
- [Jordan Shields](https://juniperadvisory.com/team/jordan-shields/) - Jordan Shields is a Partner at Juniper Advisory with over 25 years of experience advising not-for-profit hospitals and health systems on strategic and financial issues. His clients range from premier academic medical centers to some of the country’s largest health systems to critical access hospitals serving an essential need in their communities. Prior to Juniper,

## Testimonials

- [Doug Cropper, CEO, Genesis Health System](https://juniperadvisory.com/testimonials/doug-cropper-ceo-genesis-health-system/)
- [Al Deering, Board Chair, Memorial Medical Center](https://juniperadvisory.com/testimonials/john-doe-verity-health/)
- [Kevin Vermeer, CEO, UnityPoint](https://juniperadvisory.com/testimonials/john-doe-verity-health-2/)

## Press

- [Here’s what’s driving the 2026 rebound in hospital deals](https://juniperadvisory.com/press/3239/)
- [Healthcare M&A Tilts to Buyers as Independent Systems Lose Leverage](https://juniperadvisory.com/press/healthcare-ma-tilts-to-buyers-as-independent-systems-lose-leverage/)
- [Hospital M&A talks pick up but looming cuts cloud outlook](https://juniperadvisory.com/press/hospital-ma-talks-pick-up-but-looming-cuts-cloud-outlook/)
- [Why health systems are losing their partners](https://juniperadvisory.com/press/why-health-systems-are-losing-their-partners/)
- [Ascension's exit from Michigan driven by secular competition, investments](https://juniperadvisory.com/press/ascensions-exit-from-michigan-driven-by-secular-competition-investments/)
- [Diagnosis Shows Distressed Deals Ahead for Small Hospital Systems](https://juniperadvisory.com/press/diagnosis-shows-distressed-deals-ahead-for-small-hospital-systems/)
- [Government-owned hospitals seek health system partners](https://juniperadvisory.com/press/government-owned-hospitals-seek-health-system-partners/)
- [Midwest hospital M&A market heats up, but faces policy hurdles](https://juniperadvisory.com/press/midwest-hospital-ma-market-heats-up-but-faces-policy-hurdles/)
- [Windy City Windfall](https://juniperadvisory.com/press/windy-city-windfall/)
- [Healthcare Predictions for 2023: Hard Choices and Working Smarter](https://juniperadvisory.com/press/healthcare-predictions-for-2023-hard-choices-and-working-smarter/)
- [Hospital M&A volume reaches decade-plus low](https://juniperadvisory.com/press/hospital-ma-volume-reaches-decade-plus-low/)
- [Health systems eye outpatient sector as hospital M&A continues to slump](https://juniperadvisory.com/press/health-systems-eye-outpatient-sector-as-hospital-ma-continues-to-slump/)
- [HCA purchases Florida urgent care network](https://juniperadvisory.com/press/hca-purchases-florida-urgent-care-network/)
- [NorthShore, Edward-Elmhurst complete merger](https://juniperadvisory.com/press/northshore-edward-elmhurst-complete-merger/)
- [Sanford, Fairview seek new outcome in revitalized merger](https://juniperadvisory.com/press/sanford-fairview-seek-new-outcome-in-revitalized-merger/)
- [As health systems expand, communication is key for staff engagement](https://juniperadvisory.com/press/as-health-systems-expand-communication-is-key-for-staff-engagement/)
- [Kaiser, Geisinger deal may speed up hospital consolidation](https://juniperadvisory.com/press/kaiser-geisinger-deal-may-speed-up-hospital-consolidation/)

## Services

- [Board Education](https://juniperadvisory.com/services/higher-education/) - Health system boards are facing increasing complexity and evolving responsibilities, especially when navigating transformative decisions such as mergers and acquisitions. Juniper Advisory helps board members assess their roles in this shifting landscape, equipping them with the tools to make informed decisions. By starting with Board education, we ensure leaders are equipped to make decisions that
- [Partnerships & Affiliations](https://juniperadvisory.com/services/partnerships-affiliations/) - Transactions where no ownership has changed include Joint Operating Agreements, Management Agreements, clinical affiliations (both operational and contracting), purchasing groups, information technology consortiums, back-office partnerships and many other forms of contractual arrangement. We advise our clients on the pros and cons of these agreements and how they can advance the organization’s mission relative to no
- [Independence Assessments](https://juniperadvisory.com/services/strategic-advisory/) - We focus on empowering hospitals and boards with the knowledge and insights necessary for making informed decisions based on real world input. A little over half of our clients decide not to pursue transactions. We are known for our experienced, honest advice, which includes telling clients when they are better positioned to meet their objectives
- [Hospital M&A](https://juniperadvisory.com/services/hospital-ma/) - Our team is recognized for having adapted corporate merger and acquisition practices and discipline for the not-for-profit hospital industry. We have worked with all types of nonprofit hospital owners including community 501(c)3, governmental and religious, and have represented large multi-state systems, academics, small systems, large rurals, safety net and critical access hospitals. We understand the
- [Joint Ventures](https://juniperadvisory.com/services/joint-ventures/) - Juniper leads the industry in the use of joint ventures to create value, improve quality and increase access. We have achieved many "first-in-industry" joint ventures for our clients and are experienced in all forms of joint ventures such as 1) Buyer Joint Ventures where an academic medical center and for-profit organization team up to acquire
- [Non-Acute Services](https://juniperadvisory.com/services/non-acute-services/) - We have significant experience with managed care plans, behavioral health, physician groups, senior living, intellectual and developmental disability services, ambulatory surgery centers, medical office buildings, dialysis, and numerous other areas. Like acute care, mission and access are typically central features of transactions involving non-acute businesses and we understand how to maximize these without sacrificing financial

## Offices

- [Washington D.C.](https://juniperadvisory.com/offices/washington-d-c/)
- [Nashville](https://juniperadvisory.com/offices/new-york/)
- [Main](https://juniperadvisory.com/offices/chicago/)
- [Phoenix](https://juniperadvisory.com/offices/phoenix/)
- [Dallas](https://juniperadvisory.com/offices/fort-worth/)
- [Los Angeles](https://juniperadvisory.com/offices/los-angeles/)

## Categories

- [News & Events](https://juniperadvisory.com/category/news-events/)
- [Publications](https://juniperadvisory.com/category/publications/)
- [M&A](https://juniperadvisory.com/category/ma/)
- [Transaction Structures](https://juniperadvisory.com/category/transaction-structures/)
- [Role of the Board](https://juniperadvisory.com/category/role-of-the-board/)

## Tags

- [MandA](https://juniperadvisory.com/tag/manda/)
- [Transaction Updates](https://juniperadvisory.com/tag/transaction-updates/)
- [Events](https://juniperadvisory.com/tag/events/)
- [Rex James Burgdorfer](https://juniperadvisory.com/tag/rex-james-burgdorfer/)
- [FTC](https://juniperadvisory.com/tag/ftc/)
- [hospital](https://juniperadvisory.com/tag/hospital/)
- [HSR](https://juniperadvisory.com/tag/hsr/)
- [Juniper](https://juniperadvisory.com/tag/juniper/)
- [merger](https://juniperadvisory.com/tag/merger/)
- [Waller](https://juniperadvisory.com/tag/waller/)
- [safety net hospitals](https://juniperadvisory.com/tag/safety-net-hospitals/)
- [santa clara county](https://juniperadvisory.com/tag/santa-clara-county/)
- [verity](https://juniperadvisory.com/tag/verity/)
- [government hospital](https://juniperadvisory.com/tag/government-hospital/)
- [hospital governance](https://juniperadvisory.com/tag/hospital-governance/)
- [hospitals](https://juniperadvisory.com/tag/hospitals/)
- [investment banking](https://juniperadvisory.com/tag/investment-banking/)
- [mergers](https://juniperadvisory.com/tag/mergers/)
- [nonprofit](https://juniperadvisory.com/tag/nonprofit/)

## transaction-involving

- [Faith-Based](https://juniperadvisory.com/transaction-involving/faith-based/)
- [Non-profit 501(c)3](https://juniperadvisory.com/transaction-involving/non-profit-501c3/)
- [Local Government](https://juniperadvisory.com/transaction-involving/local-government/)
- [Academic](https://juniperadvisory.com/transaction-involving/academic/)
- [Investor-owned](https://juniperadvisory.com/transaction-involving/investor-owned/)
- [Physicians](https://juniperadvisory.com/transaction-involving/physicians/)

## Assignment

- [Advisory](https://juniperadvisory.com/assignment/advisory/)
- [Buy-Side](https://juniperadvisory.com/assignment/buy-side/)
- [Sell-Side](https://juniperadvisory.com/assignment/sell-side/)

## Transaction Type

- [Consolidation](https://juniperadvisory.com/transaction-type/consolidation/)
- [Member Substitution](https://juniperadvisory.com/transaction-type/member-substitution/)
- [Asset Purchase](https://juniperadvisory.com/transaction-type/asset-purchase/)
- [Lease](https://juniperadvisory.com/transaction-type/lease/)
- [Joint Venture](https://juniperadvisory.com/transaction-type/joint-venture/)
- [Management Agreement](https://juniperadvisory.com/transaction-type/management-agreement/)
- [Purchased Interest](https://juniperadvisory.com/transaction-type/purchased-interest/)
- [Strategic Advisory](https://juniperadvisory.com/transaction-type/strategic-advisory/)
- [Advisory](https://juniperadvisory.com/transaction-type/advisory/)