Gary W. Herschman and Anjana D. Patel,  Health Care Mergers and Acquisitions attorneys, in the firm’s Newark office, co-authored an article in Modern Healthcare, titled “Health Care M&A Insights: Q4 2023 & Outlook for 2024 Deal Activity.”

Following is an excerpt:

The volume of announced and closed healthcare industry deals in Q4 2023 (506) was up slightly from Q4 2022 (just under 500 transactions); however, volume remains short of pre-pandemic totals. Deal volume in December and November 2023 was 154 and 153, respectively, down from 199 in October.

As has been the case for the past several years, the life sciences & pharmaceutical subsector again had the highest quarterly deal volume (126) of any subsector, followed by digital health (76), medical device & supplies (62), and physician practices & services (57).

The following sets forth more details on consolidation activity in the major healthcare industry sectors during the end of 2023, followed by our outlook for healthcare deal activity throughout 2024. ...

Outlook for 2024

The healthcare industry entered 2023 with significant economic uncertainty driven by inflation and rising interest rates, and global security concerns; however, a recession was avoided, and consumer confidence is on the rise as we enter 2024. Overall, the outlook for 2024 appears positive, as the Fed indicated that several interest rate reductions are expected throughout this year.  Also, a recent KPMG survey found that 70% of industry leaders invested more in 2023 than expected, and 61% of them plan to further increase dealmaking in 2024.

There is no end in sight to new therapies and high-tech diagnostics and treatments, and there continues to be strong demand for innovative approaches to the provision of high-quality, cost-effective healthcare. There also is an increase in potential virtual and AI-driven care use cases, as well as a continued trend of more advanced health care services (including major surgical and interventional procedures) being performed in an outpatient setting (e.g., ambulatory surgery centers vs. hospitals). All of the foregoing is likely to generate increased merger and acquisition activity in these outpatient care focused sectors during 2024 and beyond.

For the same reasons, we anticipate  growing demand in 2024 for acquisitions of physician groups in most specialties, with continued interest in primary care, dermatology, fertility and eyecare, and the fastest growth in the following newer areas of investor focus – cardiology, orthopedics, plastic surgery, ENT, and medspa.

Moreover, we expect a continued growth trajectory throughout 2024 in the full continuum of behavioral care, including residential care, partial hospitalization, as well as the full continuum of treatment for depression, autism, substance abuse, and addiction disorders. This activity is spurred on by the ongoing national opioid crisis, and the significant uptick in mental health disorders in adolescents and young adults in the aftermath of the COVID pandemic and related isolation and societal disruption.

Another consequence of the substantial growth of care in outpatient settings, and its inverse impact on hospitals’ historic “bread and butter” services, is further consolidation of hospitals – many of which are part of smaller health systems ($1-$5 billion) in a particular state -- into larger, mega-systems with revenues in the $10-$25+ billion range across multiple states. Thus, although we expect to see fewer hospital consolidations in 2024, the transactions will be bigger, involving (or creating) mega, multi-state hospital systems.

On the flipside, there are certain factors that could temper transaction activity this year. First, there is not expected to be a robust domestic healthcare policy agenda for 2024, and political uncertainty created by this fall’s Presidential and Congressional elections could create a bit of hesitance as investors contemplate how any potential policy changes in 2025 could impact their investment priorities.

Additionally, the Federal Trade Commission and Department of Justice are expected to continue to increase scrutiny of larger merger transactions moving forward, as evidenced by their enforcement actions taken throughout 2023.

Lastly, it is also possible that investor interest may be softened due to increasing global insecurity, as a result of the continuing war in Ukraine and escalating conflicts throughout the Middle East.

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