After a decade-long downturn, hospital mergers and acquisitions (M&As) increased dramatically in 2010. From 2007 to 2009, these transactions dropped by 35 percent, with 2009 witnessing the lowest number on record. In 2010, M&As rose by 25 to 30 percent, and most experts agree that this trend is likely continue.

During the '90s, hospital consolidations were maneuvers designed to increase market share or expand service lines. Today's driving forces are more likely to include improved access to capital, garnering economies of scale, or simply, survival.

Industry analysts believe that the uptick in activity is largely due to health care reform, as the new health law will extend coverage to an additional 32 million people, making much of the uncompensated care burden a non-issue. Since the Patient Protection and Affordable Care Act passed in March 2010, there have been 28 deals involving 57 hospitals that have totaled $3.3 billion.

The economic meltdown and slow recovery have also played a significant role in encouraging the M&A trend. Cash-strapped hospitals are having difficulty borrowing the funds necessary to keep up with diagnostic and treatment technology, as well as the information technology mandated by health care reform. One of its major provisions calls for improving care coordination and reducing financial waste via the integration of electronic health records. Consequently, there is a mandate to invest in IT systems to improve coordination of care. Struggling hospitals view partnerships with larger systems as a way to obtain these critical upgrades.

In addition, new payment models, such as bundled payments and accountable care organizations encourage integrated systems by emphasizing reduced duplication of services, early intervention for emerging problems, and high quality, low cost care. Add in the prospect of Medicare reimbursement reductions, increasing reporting requirements and carve outs for deficiencies such as high nosocomial infection and readmission rates, and you get an environment favoring mergers and acquisitions.

A new wrinkle in the current M&A scenario is that private equity and large institutional firms are now showing an interest in acquiring hospitals. Traditionally, they have shied away from health care, deeming it too highly regulated, expensive to run, and subject to the will of physician power-brokers and rising patient expectations. This development reflects a corporate recognition that health care is a growth industry, albeit a slowly growing one. Private investors have modified their return expectations and view healthcare as a long term investment.

Also new this time is an unprecedented interest in distressed facilities. Since many previously stable organizations are faltering, acquiring organizations view them as an opportunity to seize a bargain, and turn it around with a relatively small investment.

Lacking a crystal ball, it's difficult to say whether predictions of additional M&As are imminent, but given the current health care and economic climate, this trend is likely to be a part of our industry's future.

In this section, we present some of our top interim healthcare leaders who are completing their current assignments - and are ready to join your organization.

Candidate - Chief Executive Officer

Seasoned executive with over 30 years of experience in senior healthcare management, hospital turnaround management, strategic planning, operations, program development and medical staff relations at Chief Executive Officer and Vice President levels. Currently available. Click to view this resume.

Candidate - Emergency Services Director

Senior nursing executive whose leadership skills in quality improvement, customer satisfaction and administration will contribute to exceptional organizational performance and improved patient care outcomes. Seasoned professional with more than 25 years progressive and diversified experience in health care management, business and nursing administration. Currently available. Click to view this resume.

Candidate - Healthcare Executive

An experienced healthcare executive with more than 15 years of success in increasingly responsible roles. Skilled in delivering high quality, efficient services and operations management in fast-paced, complex, and multi-disciplinary environments. Successes include leading medical units, departments, and organizational-wide ambulatory and ancillary services at leading academic medical centers. Currently available.Click to view this resume.

For more information about these and other great interim healthcare executives, contact Jeff Souza, BSN, Chief Executive Officer, at 508-927-6890.

Our current opportunities include:

• Interim Vice President, Physician Services- Massachusetts
• Interim Director, Laboratory Services - Vermont
• Chief Financial Officer- Washington, D.C.
• Chief Operating Officer - Massachusetts
• Interim Director, Radiology - Massachusetts
• Interim OR Manager- New York
• Interim Perioperative Director- Vermont
• Director, Financial Planning & Analysis- Massachusetts
• Manager of Coding- Massachusetts
• Interim Perioperative Director - Rhode Island
• Interim Manager, Ancillary Services - Massachusetts

"It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change."
~ Clarence Darrow