Local Government

Riverview Health Finalizes Management Agreement with Parkview Health

November 11, 2025

Transaction Involving: Local Government

Transaction Type: Management Agreement

Assignment: Sell-Side

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 incorporates performance-based incentives tied to operational and clinical results while preserving county ownership. The partnership is designed to enhance services, drive growth, and improve patient care for the communities served by Riverview Health across Hamilton County, Indiana.

The agreement enables both organizations to collaborate on operational improvements and clinical innovation, while establishing clear performance expectations and growth opportunities across Riverview Health’s network.

Juniper’s Role
Juniper Advisory served as strategic advisor to Riverview Health and Hamilton County. Juniper assisted the Board, County, and leadership with the evaluation of the management services proposal and arrangement, including providing insight on management agreements and agreement structure.  Juniper’s focus was upon Riverview Health’s objectives of preserving local ownership, supporting growth, and incentivizing performance.

About Riverview Health
Riverview Health is an independent, community-based health system in Hamilton County, Indiana. The system includes a 156-bed hospital in Noblesville, a 16-bed hospital in Westfield, three combined ER/urgent care facilities, and ten primary care locations. Riverview Health provides more than 25 specialty services to the communities it serves.

About Parkview Health
Parkview Health is a nonprofit, community-focused health system serving Indiana and northwest Ohio, with 15 hospitals and an extensive network of primary and specialty care physicians. Committed to improving health and inspiring well-being, Parkview Health’s management services agreement with Riverview Health supports its mission while advancing operational excellence, expanding access to care, and fostering growth across the communities it serves.

Blount Memorial Hospital in Blount County, TN joins Prisma Health

December 3, 2024

Transaction Involving: Local Government

Transaction Type: Lease Member Substitution

Assignment: Sell-Side

Blount Memorial Hospital in Blount County, TN joins Prisma Health

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Liberty Hospital joins The University of Kansas Health System

July 1, 2024

Transaction Involving: Academic Local Government

Transaction Type: Lease Member Substitution

Assignment: Sell-Side

Liberty Hospital has joined The University of Kansas Health System. We advised Liberty Hospital on this transaction.

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Monterey County’s Natividad Medical Center explores strategic growth opportunities

July 1, 2021

Transaction Involving: Local Government Non-profit 501(c)3

Transaction Type: Strategic Advisory

Assignment: Advisory

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.

Santa Clara County has acquired three facilities from Verity Health

March 1, 2019

Transaction Involving: Investor-owned Local Government

Transaction Type: Asset Purchase

Assignment: Buy-Side

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.

Indian River Medical Center has joined the Cleveland Clinic

October 12, 2018

Transaction Involving: Academic Local Government Non-profit 501(c)3

Transaction Type: Lease Member Substitution

Assignment: Sell-Side

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.

Trinity Hospital of Augusta has been acquired by University Health Care System

July 12, 2017

Transaction Involving: Investor-owned Local Government

Transaction Type: Asset Purchase

Assignment: Buy-Side

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.

Alpena Regional Medical Center has been acquired by MidMichigan Health

April 1, 2016

Transaction Involving: Academic Local Government

Transaction Type: Asset Purchase

Assignment: Sell-Side

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.

Community Health Center of Branch County has entered into a phased merger with ProMedica

February 16, 2016

Transaction Involving: Local Government Non-profit 501(c)3

Transaction Type: Consolidation

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.

Lenoir Memorial Hospital has entered into a management agreement with Novant Health

May 1, 2015

Transaction Involving: Local Government Non-profit 501(c)3

Transaction Type: Management Agreement

Lenoir Memorial Hospital has entered into a management agreement with Novant Health. We advised Lenoir Memorial Hospital on this transaction.

Port Huron Hospital has joined McLaren Health Care

May 2, 2014

Transaction Involving: Local Government Non-profit 501(c)3

Transaction Type: Member Substitution

Port Huron Hospital has joined McLaren Health Care. We advised Port Huron Hospital on this transaction.