Hospital and health system M&A activity ends 2025 with momentum

CHICAGO - January 15th, 2026 - A total of 46 hospital and health system transactions were announced in 2025, a decrease from 2024, according to the latest analysis from Kaufman Hall, a Vizient company. Transacted revenue for 2025 was $18.5 billion-the lowest amount since Kaufman Hall began tracking this data-the result of very low activity levels in Q1 and Q2.

Despite low numbers for the year, M&A activity picked up in Q3 and showed sustained momentum with 17 announced transactions in Q4. The fourth quarter also saw four "mega mergers," or transactions in which the annual revenue of the smaller party exceeded $1 billion. More than half of the year's transacted revenue-$9.8 billion of the $18.5 billion total-was recorded in Q4.

"2025 hospital and health system M&A activity started slow given the policy and market uncertainty, but momentum returned by the end of the year," said Anu Singh, Managing Director at Kaufman Hall. "Some of the most interesting activity in 2025 occurred outside of hospital and health system transactions, with organizations making significant deals in acquiring ambulatory care, lab services, and behavioral health providers. We anticipate this trend to continue in 2026."

Singh says financial distress continues to drive transaction activity, with the percentage of transactions involving a financially distressed party in 2025 hitting 43.5%, a record high. Data show this percentage has been steadily increasing since 2022 and will likely continue into 2026.

November Hospital Performance

Hospitals' financial and operational performance declined in November, with lower volumes across all services, according to Kaufman Hall's most recent National Hospital Flash Report.

"While month-to-month hospital performance softened in November, on a year-to-date basis, revenue and margins are still strong compared to previous years," said Erik Swanson, Managing Director and Data and Analytics Group Leader at Kaufman Hall. "The continued rise in expenses requires attention. For hospital leaders, managing overall spend as patient volumes fluctuate is an ongoing challenge."

The National Hospital Flash Report draws on data from more than 1,300 hospitals from Strata Decision Technology, LLC.

About Kaufman Hall, a Vizient Company

Kaufman Hall, a Vizient company, provides management consulting solutions to help society's foundational institutions realize sustained success amid changing market conditions. Since 1985, Kaufman Hall has been a trusted advisor to boards and executive management teams, helping them incorporate proven methods, rigorous analytics, and industry-leading solutions into their strategic planning and financial management processes, with a focus on achieving their most challenging goals.

Kaufman Hall services use a rigorous, disciplined, and structured approach that is based on the principles of corporate finance. The breadth and integration of Kaufman Hall advisory services are unparalleled, encompassing strategy; financial and capital planning; performance improvement; treasury and capital markets management; mergers, acquisitions, partnerships, and joint ventures; and real estate.

CONTACT: Toby Howard, [email protected], (571) 201-7409