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More hospitals and health systems engaged in mergers and acquisitions in 2024, and many of those deals involved an organization in financial distress, according to a new 

There were 72 announced hospital mergers in 2024, up from 

 in 2023. For more perspective, there were 

53 hospital mergers and acquisitions in 2022

Nearly one in three hospital mergers (30.6%) involved a party in distress, which represents a record, according to Kaufman Hall, the healthcare consulting firm. In 2023, 27.7% of hospital deals involved a provider in financial distress, and that was a record, albeit a short-lived one.

Many of those distress-driven deals involved Steward Health Care, the for-profit firm that filed for bankruptcy and 

In addition, 2024 also witnessed a peak percentage of deals involving a health system divesting some of its hospitals, with some systems leaving certain markets. Many of those deals involved Steward facilities, but other systems shifted strategies. In 2024, Tenet Healthcare Corp. 

More than half (62.5%) of the hospital deals in 2024 involved divestitures, Kaufman Hall said.

Many hospitals continue to struggle financially in the wake of the COVID-19 pandemic, and the hospital mergers offered more evidence of the difficulties of some providers.

The percentage of deals involving the smaller party with a credit rating of “A-” or higher fell to an all-time low, Kaufman Hall said. Only 2.8% of the deals in 2024 involved a smaller party with a rating of at least “A-”, down from 12.3% in 2023.

In previous years, many deals involving hospitals in financial trouble have been smaller hospitals, but there are larger hospitals in distress seeking partners, Kaufman Hall notes. In 2024, the average size of a distressed hospital in a merger rose to $401 million, nearly double the figure just two years earlier ($219 million in 2022).

The past year has seen some large mergers, including mega-mergers where even the smaller party in the deal has more than $1 billion in revenue. 

Sanford Health and Marshfield Clinic Health System

 announced plans to come together last summer, and they completed their merger last week, creating a $10 billion system.

But Kaufman Hall says another trend is emerging, judging from the deals seen in 2024. More hospitals and systems are striking deals with much larger partners. Even some that aren’t exactly distressed are looking for larger systems to maintain their viability, Kaufman Hall notes.

Such deals include Northwell Health’s planned acquisition of Nuvance Health, 

. Northwell, New York’s largest health system, operates 21 hospitals. Nuvance owns seven hospitals, with four in Connecticut and three in New York. Nuvance has struggled with financial losses.

Risant Health, a subsidiary of Kaiser Permanente, 

, a North Carolina hospital system. The deal follows Risant’s purchase of the Geisinger health system in Pennsylvania.

Greg Adams, CEO of Kaiser Permanente, has said 

Risant is looking to acquire more hospital systems

 in the coming years. However, he has said Risant is not looking to acquire hospital systems in financial trouble.

“We’re looking for organizations that on their own can be financially sound,” Adams said at the HLTH Conference in October.

In another merger that’s gained attention, General Catalyst, the venture capital firm, reached 

a definitive agreement to buy Summa Health

 in Ohio in a $485 million deal. A subsidiary of General Catalyst, Health Assurance Transformation LLC, dubbed HATCo, and Summa Health announced the agreement in November.

While hospital mergers have risen for the third consecutive year, it’s worth noting that hospital M&A activity still hasn’t returned to pre-pandemic levels.

There were 92 mergers in 2019, and 79 in 2020, the first year of the COVID-19 pandemic, although work on some of those 2020 transactions had begun the previous year. Hospital mergers fell to a record low of 49 in 2021.

California children’s hospitals complete merger

Many of the year’s transactions involved systems or hospitals on shaky ground. There were other noteworthy trends in mergers over the past year.

Topic

Hospital mergers rose in 2024, driven by ‘record’ number of distressed providers

Artificial intelligence emerged as one of the leading issues in healthcare and dominated conversations at health technology conferences over the past year.

In 2025, expect AI to remain a prime area of attention in the healthcare industry.

More than a dozen healthcare leaders and executives offer their projections of what to expect with the use and development of AI in the coming year.

They weigh in on how hospitals and healthcare organizations will use AI in their business operations and how AI technologies will be used in patient care.

Greg Samios, president & CEO at Wolters Kluwer Health Clinical Effectiveness

“I think as these generative AI technologies start working through their value add models, I think we'll see a bigger impact. Six months ago it was like, ‘What do you have that says, generative AI on it?’ Now we're at, ‘How are you applying that to your core proposition?’ I think as we go into next year, I think we're going to see more real value there and more demonstrable value there. I think we're seeing signs of it right now.”

Looking at how hospitals will be using AI in 2025

Ronald Rodriguez, MD, PhD, professor of medical education at UT Health San Antonio

“Artificial intelligence has the possibility to transform diagnosis, treatment, and patient care. AI will help clinicians make quicker, more precise decisions, enable more direct interactions with patients, enhance communication and provide personalized care.”

Nate Perry-Thistle, chief product & technology officer of CipherHealth

“Despite AI’s potential, healthcare organizations remain cautious about its widespread deployment, especially for patient-facing roles. In 2025, we anticipate a ‘measured adoption,’ aimed at demystifying AI, that will focus on supporting healthcare operations without compromising care quality. This means AI will be embraced incrementally—first to assist in data processing, workflow automation, and patient outreach—laying the groundwork for eventual clinical applications. This gradual, strategic approach helps systems build trust and confidence in AI’s role as a supportive force in healthcare.”

Shaan Khurshid, MD, cardiologist, Massachusetts General Hospital

"I think in 2025 we will see implementation of generative artificial intelligence (AI) language models (i.e., chatbots) for some aspects of routine clinical care, such as the preparation of patient communications, generation of preliminary diagnostic test reports, or summarization of patient medical records."

Jonathan Shoemaker, CEO of ABOUT Healthcare

“In recent years, the increased demand for care has placed unprecedented strain on provider resources, highlighting the inefficiencies of the transactional care delivery model. In 2025, AI-driven patient throughput will empower providers to deliver more accessible, efficient, and personalized care. These technologies will streamline workflows, integrate data, and guide patients to the optimal care setting, reducing administrative burdens and enhancing clinical decision-making. By improving engagement and outcomes, technology can support providers in aligning with value-based care goals and adapting to the evolving needs of patients in a rapidly transforming healthcare landscape.”

Kim Perry, chief growth officer, emtelligent,

“In the coming year, health systems will increasingly be called upon to scale quality and operational improvements across their networks, while simultaneously battling a very real clinician burnout crisis. By automating complex billing, coding, and documentation tasks, medically aligned AI will help protect revenue, reduce administrative load, and free clinicians to focus on patient care. Beyond financial impact, AI will close workflow gaps, streamline care transitions, and reduce readmissions, making it indispensable for improving system-wide quality, efficiency, and revenue.”

Stephanie Lahr, MD, president of Artisight

“Healthcare's next frontier will be shaped by computer vision technologies that enhance, rather than replace, clinical decision-making. Just as we've seen in other industries, capabilities evolve gradually and healthcare will experience a measured progression in AI adoption, with each advancement carefully balanced against ethical considerations and governance frameworks. The key will be ensuring these systems adapt to local healthcare environments while maintaining transparency and trust.”

Anurag Mehta, CEO & co-founder, Omega Healthcare

“In 2025, the healthcare industry will start to witness a dramatic shift in revenue cycle management as healthcare providers move beyond viewing AI as just a cost-cutting tool to embracing it as a strategic imperative for improving patient care and financial outcomes. The emerging concept of 'responsible RCM' will gain traction, where providers leverage AI not just to maximize revenues but to also create more transparent, patient-friendly financial experiences while ensuring accuracy and compliance.”

Chris Hartemayer, EVP of enterprise operations at R1

“In 2025, providers will rely heavily on AI to meet the dual challenges of operational efficiency and patient satisfaction. From guiding patients to the right care setting to automating revenue cycle processes, AI will create a more streamlined and responsive healthcare ecosystem. By integrating these technologies into daily operations, providers will enhance care delivery, reduce burnout, and build sustainable practices capable of thriving in a rapidly changing industry.”

Sandra Johnson, SVP of client services at CliniComp

“In 2025, the adoption of AI in healthcare will advance significantly, bringing more sophisticated applications in predictive analytics, personalized medicine, and clinical decision support. This evolution will drive substantial improvements in patient outcomes, operational efficiency, and clinician satisfaction. By focusing on workflow automation and reducing the time spent in EHR systems, we can reintroduce joy into healthcare, allowing providers to dedicate more time to patient care and fostering a more fulfilling work environment.”

“It is becoming more financially and administratively difficult to run a healthcare provider practice. Staff shortages and increasing regulatory complexities are contributing to an ever-growing administrative burden felt by practices across the United States. As we head into 2025, I predict that practices that embrace resource-saving solutions like AI-enabled ambient scribing, mobile patient engagement platforms, and tech-enabled revenue cycle services, will be better suited to face the business and financial challenges presented to them.”

“The increased use of AI and wearable technologies will only expand the capabilities of decentralized trials. Companies are developing AI-powered diagnostics that analyze biomarkers that more accurately reflect disease state that can be used for assessing trial participants’ data. AI can also detect anomalies in health data provided by smartwatches and other wearable devices, flagging concerning data to medical monitors to enable faster decision-making and responsiveness to safety issues.”

Dr. Mimi Winsberg, co-founder and chief medical officer at Brightside Health

“AI will be widely adopted as a time-saving assistant for clinicians. Most clinicians welcome AI tools and assistants to help with automated tasks and case note generation, and user satisfaction thus far has been high. These tools can help them spend their time with patients, rather than in repetitive administrative tasks. In addition, AI will improve diagnostic accuracy and predict treatment response. AI will also drive care insights directly to patients. As models become more refined, there will be greater trust in technology that actively supports both patients and clinicians, making mental health care more proactive and personalized.”

Eric Rock, CEO and founder of Percipio Health

"In the coming year, we are going to see the value of AI begin to prove out in a few specific use cases, such as population health monitoring, giving many providers and payers the confidence they have been waiting for to adopt AI technology. For example, many provider and payer organizations will begin using AI-powered applications to collect a broad range of health signals, such as device-free biometrics, brain health assessments and medication scanning. These will be used for earlier prediction of disease risks and avoidance of acute care utilization at much broader scale, leading to improved value-based measures that we have all been seeking."

Kengo Takishima, president and CEO, Baylor Genetics

“In 2025, artificial intelligence (AI) is poised to become an even more pivotal force in genetic testing and precision medicine, driving advancements that can reshape patient care. As the industry continues to generate immense volumes of genomic data at both individual and population levels, the focus will increasingly shift to leveraging AI to transform this data into actionable clinical insights. This will be particularly critical for identifying pathogenic variants and mutations that influence medical diagnoses, treatment planning, and policy development.”

Leaders and analysts offer their projections on how AI will be used in business operations and in improving patient care.

AI in healthcare: What to expect in 2025

 – While AI and health tech issues are taking up much of the oxygen at the HLTH conference, the election is on the minds of many of those in attendance.

In two weeks, and perhaps a bit longer after mail-in ballots are tabulated, voters will decide if Kamala Harris or Donald Trump will serve as the next president. The next occupant of the White House could have a big impact on the nation’s healthcare policy.

During a session at HLTH Tuesday morning, Andy Slavitt and Seema Verma weighed in on the consequences of the 2024 election and its implications for healthcare, costs and access. Verma served as administrator of the Centers for Medicare & Medicaid Services during the Trump administration, while Slavitt served as acting CMS administrator under President Barack Obama.

In the 2024 contest, unlike recent elections, Slavitt said, “Healthcare is not the main event.”

Harris has made protecting the Affordable Care Act a key part of her campaign, which 

she highlighted at the Democratic National Convention

. Trump attempted to abolish the healthcare law while he was president, although he has said in recent months he wants to improve the law. Slavitt noted the law remains popular, and while it’s not perfect, it has helped many get access to care.

“It’s hard to find something that’s a whole lot better,” Slavitt said.

Verma said that Trump was focused on the cost of healthcare for Americans during his presidency, and he’d likely retain that approach.

“He was in favor of wanting people to have more health insurance,” Verma said. “The concern was affordability.” 

Verma added, “For both candidates, there is a larger concern of general affordability in healthcare.”

Harris has also made abortion rights a centerpiece of her campaign, and that’s likely been the single biggest health issue in the race.

The vice president said she wants to ensure women have freedom to make their own choices. She’s also pointed to women having emergency care delayed or denied in states with strict abortion laws. And she’s repeatedly referenced doctors being prevented from caring for patients in emergencies, even for women who weren’t trying to end their pregnancy.

“She wants to make things more affordable, easier, get rid of the red tape …. And she wants to protect reproductive freedom,” Slavitt said. “Those are the things we know for sure.”

Trump has said he views abortion as an issue for states to decide, though 

, he wouldn’t answer the question about whether he would sign legislation to prohibit abortions nationwide if it reached his desk.

Both Slavitt and Verma generally agreed that the next president’s impact on healthcare will depend heavily on the people they choose to serve in key healthcare posts in the next administration.

“It’s going to be more about the personnel in place,” Slavitt said.

Similarly, Verma said, “It really is going to be turned to whoever’s running the administration.”

The entire House and half the Senate are up for grabs in the election, and they could be divided with narrow majorities, regardless of which party ends up in control.

For that reason, Verma said, the dynamics on Capitol Hill will make it hard to get things done.

“I don’t think we’re going to see a big, huge piece of legislation around healthcare,” Verma said.

If there are significant changes in federal healthcare policy, they will likely come from regulation, rather than legislation.

However, federal agencies could face new constraints in regulatory policy, due to 

 in the summer relating to what’s called the Chevron doctrine. For decades, the court held that when Congress hasn’t spelled out its intent on federal law, courts should generally defer to regulatory agencies and their interpretation of statutes. The justices upended that precedent this summer.

Slavitt said that weakens the role of regulatory agencies.

“The spillover will be real,” he said. “You’ll see a more restrained set of regulations.”

He also envisions the possibility that agencies may simply turn to Congress. And he said that’s problematic.

“Congress just isn’t that good,” he said. “They can’t foresee the future.”

Slavitt said it could unfold in ways to please and anger different groups. He said it would be harder for a new administration to simply impose new work requirements for Medicaid, but it could also weaken public protections.

Verma offered a similar perspective about the difficulties with the new post-Chevron landscape, saying, “I think it makes it a lot harder for agencies.”

Federal agencies are likely to see more lawsuits, Verma said, including on issues “that we consider to be settled.”

Verma said a second Trump administration wouldn’t see any cuts to Medicare, saying, “He’s very protective of the program.”

She noted the increasing scrutiny that has emerged around Medicare Advantage programs. While there is some bipartisan interest in Medicare Advantage reforms, Verma said some efforts may be going too far.

“My guess is the Trump administration may look at that and say, did we over-rotate?” Verma said.

As far as Medicaid, Verma said that another Trump administration would look at how Medicaid dollars are spent and will ensure the aid is going to recipients.

Verma also said a Trump administration would definitely give more deference to the states regarding Medicaid.

Harris has proposed a new Medicare benefit, Medicare at Home, which would offer beneficiaries the chance to get services and aides to help seniors stay in their homes.

Slavitt noted that the proposal appeals to the “sandwich generation,” the group of Americans who are raising children and caring for aging parents. “She wants to bring some relief,” he said.

Slavitt said that there are key details, including how a Harris administration would pay for such a program.

Still, he said, “That’s a really interesting and strong priority of hers.”

As far as Medicaid, a Harris White House would ensure that there are no work requirements to qualify for assistance, Slavitt said.

Earlier in the HLTH conference, Chelsea Clinton, the daughter of Bill and Hillary Clinton, headlined a session on reproductive freedom.

Clinton, vice chair of the Clinton Foundation, made it clear that she’s supporting Harris, and she said the Supreme Court’s decision to upend Roe v. Wade has endangered American women. Nearly one in three American women live in a state that has an abortion ban.

Women outraged over the loss of abortion rights could make a difference in the election, Clinton said. She pointed out the abortion question is a defining issue in the presidential election but goes beyond the race for the White House. She noted that 10 states, including Nevada, host of the conference, have ballot questions regarding abortion rights on Election Day.

 voters have approved measures to preserve abortion access.

“There is wide and resounding support for women to access the healthcare they need,” Clinton said.

With two weeks until Election Day, Andy Slavitt and Seema Verma talked about what will change, and what won’t, no matter who wins the White House. 

The 2024 election and the implications for healthcare | HLTH 2024

Results of the most recent American College of Healthcare Executives annual survey indicated that the top issue confronting large health systems in 2023 was — for the third year in a row — workforce challenges. These challenges, which encompass physician shortages and burnout, can trigger other issues, such as financial challenges, patient access to care, and patient satisfaction.

As a health system executive, you likely are not surprised by this result. Chances are, you’ve experienced this reality personally at your health system and read the numerous studies that give weight to it. Retaining and attracting outstanding physicians is becoming more difficult, in part because the traditional model of care in which many physicians are practicing is causing burnout, which in turn is leading to hundreds of thousands of those physicians leaving the medical profession.

“Exploring alternate models of care is one way to address these critical workforce issues,” said Alfredo Fernandez-Concha, Chief Growth Officer, CCPHP. “Evidence is clear that the traditional model of care isn’t working. In fact, it’s jeopardizing patients’ quality of care and physicians’ ability to practice. What’s needed is a model that puts the focus back on exceptional, connected, and collaborative healthcare. What’s needed is the concierge medicine model.”

The membership (concierge) model of medicine is growing and, according to research, is “set to own a third of the primary care market by 2030.” This model, which charges patients a fee in exchange for enhanced services and greater connectivity to their physician, can remedy some of the major issues a health system faces, from workforce and financial challenges to patient satisfaction and care.

The first and best step to establishing a concierge model of medicine at a health system is to work with a creative and knowledgeable partner who can provide guidance through every step of the transitioning process to ensure you thrive today and in the future. A leading, award-winning concierge medicine company known for its best-in-class practices is Castle Connolly Private Health Partners.

Thanks to CCPHP’s unique T.H.R.I.V.E. solution, health systems and physicians thrive in their partnership with us. We provide a program that can:

 practices and return them to the core reasons physicians chose to practice medicine.

, supportive, and exceptional experience to you, your physicians, and your patients.

 and thorough support, including practice analysis, business planning, marketing, and more.

Enable your health system and physicians to retain your 

 options that will meet and adapt to the needs of your health system and your physicians’ practices.

 your Members to achieve optimal wellbeing.

There are numerous other benefits that will help your health system thrive in your partnership with CCPHP.

Operational and Compliance Best Practices.

 You’ll receive support from experts in membership-based medicine, including experienced marketing teams, health coaches, wellness experts, legal advisors, and Member Advisors. This full-coverage support will enable you to focus your time on managing your health system instead of doing administrative work, enable physicians to focus on treating patients, and enable patients to receive the high-quality, one-stop care they want. This full support also allows speed to market, reduces the learning curve of concierge for our partners, and provides other turnkey solutions such as a billing and financial services platform.

A health system that offers a concierge model option increases its ability to retain high-value physicians and recruit new ones because the model provides the physician with greater career satisfaction, a more balanced workload, more time with patients, and greater financial rewards. In addition, CCPHP’s Member Advisors and patient advocates handle patient navigation, make follow-up calls, and provide ongoing support throughout the referral process, enabling the physician to focus on treating patients.

The value of the enhanced services inherent in the concierge model — from greater convenience to robust health-related tools — exceeds consumer expectations and satisfaction time and again, which increases your ability to retain patients in your network as well as attract new ones. The exclusive SENS Solution® Wellness Program, for example, supports physicians in their efforts to empower their patients to live a healthier lifestyle by offering benefits such as personalized health coaching; wellness webinars, blogs, and newsletters; and affinity arrangements. In addition, CCPHP has a substantial national footprint, a referral network of national and international Top Doctors® outside of your market.

The executives we partner with to establish a concierge model at their health system experience 120%-130% growth per year in a crowded and ever-evolving industry. In addition, it enables them to deliver high-margin service with high patient satisfaction to an average membership of about 400 members per physician.

We partner with only the best of the best. So should you. To learn more about a way of operating that will resolve your pressing workforce, financial, and patient issues, 

Fix Your Health Systems’ Workforce Challenges With the Concierge Medicine Model

Undeniably, the healthcare nursing workforce has faced unprecedented stressors exacerbated by the pandemic.

While the majority of research on burnout has focused on nurses and physicians from the clinical perspective and chief executive officers (CEOs) from a leadership perspective, there is a need for more research on the factors that may contribute to the burnout of chief nursing officers (CNOs) and system chief nurse executives (CNEs).

Faced with a heavy burden of stress and needs from their overstretched teams, CNOs and CNEs are a distinctive specialty within nursing that have unique challenges. While many provider organizations have made efforts to help address the wellbeing of front-line nurses, few programs exist that are tailored for the specialized role of these nurse executives.

With the cost of CNO and CNE turnover for health systems at more than $1.5 million per employee, burnout is not only a workforce issue but a financial sustainability challenge that hospital leaders cannot afford to ignore.

Vizient’s 2024 chief nursing officer wellbeing survey identifies leadership fatigue and secondary trauma as key drivers in burnout and turnover.


Jack Coleman

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