The hospital system has expanded its presence in some rural areas, so patients don't have to drive for hours to receive specialized care.
Centura Health—an organization with 6,000 physicians, and $5 billion in net patient revenue—has made its first acquisitions in about seven years, adding two more hospitals to its healthcare system.
The acquisitions of St. Elizabeth Hospital in Fort Morgan, Colorado, and St. Catherine Hospital in Dodge City, Kansas, were completed on May 1, 2022, and closed for $135 million. The integration of these two organizations into the Centura Health system is part of the organization's plan to build a strongly connected system of hospitals in rural communities.
"When we developed our strategic plan, we realized about two-thirds of our growth is in existing markets and building up services programs—we're building two hospitals in geographies that we don't currently have a presence in," says Peter Banko, CEO of Centura Health. "Then we identified about a third of our growth—going from a $3.5 dollar system to a $7 billion system—we identified about a billion dollars in growth through acquisitions."
Once Centura Health realized this, it started to look at potential partnerships in Colorado, western Kansas, and northern New Mexico—all rural areas that have trouble attracting cardiologists, orthopedists, and other specialty physicians.
"Right now, patients at our hospital in Garden City, Kansas, have to drive two-and-a-half hours away to Wichita for specialized care," Banko says. "The same is true in Dodge City, and we've used Dodge City to start to get scale in that market and start to build up specialty care so that people in those communities don't have to drive [far] for specialty care. We'd love to have one more similar size acquisition in western Kansas. That would give us a population base of a little over 100,000 and we could keep care local."
Hospitals in small rural communities have been hit hard by the COVID-19 pandemic, with the Center for Healthcare Quality and Payment Reform estimating that 200 of these facilities are in danger of closing in the next two to three years. However, Banko says that Centura Health has been able to weather this storm thanks to supportive resources and financial operating discipline.
"We worked hard on associated physician engagement, quality, safety experience, being a high-reliability organization, and that served us well through the pandemic," he says. "We've taken some financial hits, like other organizations. The last three or four months have not been great for us. But our quality and safety improved, and our associate engagement is in the 75th percentile. Our financial performance, while weaker than it was the last four months, is stronger than most systems in the country, and we didn't see the declines that others did."
Despite that weaker than usual financial performance, Centura Health doesn't plan to give up on expanding its system through acquisitions and by building new hospitals.
"Rural communities have suffered," Banko says. "Systems like ours can help support them with the scale that they need to be able to keep care local. So, we view the rural healthcare market as very attractive."
In general, hospital M&A activity has been on a downswing, according to data from Kaufman Hall. There were 34 announced hospital transactions in 2021, down from 62 in 2020, which was a decline from 71 in 2019. The decline in hospital and health system M&A activity can be attributed to fewer independent, unaffiliated community hospitals looking for partnerships, says Kaufman Hall. Organizations are also becoming more selective in the deals they are seeking, wanting partners who are making an impact through new technology, who have enhanced intellectual capital, and have access to new markets.
"The pandemic has focused new attention on issues of health equity and underserved populations, and addressing these issues is becoming a stated partnership goal," writes Anu Singh, managing director of partnerships and the M&A practice leader with Kaufman Hall. "This trend is also evident in the growing number of partnerships between health systems and specialized behavioral, home health, and other non-acute providers … as health systems work to address the needs of populations affected by the social isolation and other adverse impacts of the pandemic."
The healthcare landscape has been irreversibly altered over the last two years and this change has forced hospitals and health systems to reevaluate how they can best integrate the needs of the patients with their own financial needs.
As for Centura Health, the system is currently in talks with several potential partners about acquisitions over the next few years, but Banko didn't offer more detail than that.
"M&A is an interesting game," he says. "If you look at some national stats, about 70% of them fail. We're intentional about making sure we find organizations that share our mission, values, and vision, and that they see the future the same way we do. We put a lot of effort not just into the deal, but into the integration of the organization into the system. A lot of people do M&A and don't get it right, but I think we've figured out how to do it right."
Amanda Schiavo is the Finance Editor for HealthLeaders.