Hospital M&A on pace for busiest year since pandemic as megamergers mount

Announced hospital and health system mergers and acquisitions in 2026 have already surpassed the total number in 2025 and are on track for the most transactions since the start of the COVID-19 pandemic, according to an Oct. 13 report from Kaufman Hall.

Kaufman Hall counted 16 transactions announced in the third quarter, following 22 in the first quarter and 18 in the second, according to the firm’s quarterly reports. That brings the 2026 total to 56, compared with 46 in all of 2025, which was the lowest annual count since Kaufman Hall began tracking hospital transactions in 2011.

For the third quarter in a row, more than one megamerger was announced. Kaufman Hall defines a megamerger as a deal in which the smaller party has more than $1 billion in annual revenue, and the firm said 2026 could set a record for these transactions. Third-quarter deals totaled $8.2 billion in transacted revenue, and the average seller had about $586 million in annual revenue.

Kaufman Hall pointed to two forces driving the surge. Large, financially stable systems are pursuing deals to secure transaction commitments, strengthen their competitive positions and add new capabilities. At the same time, midsize hospitals and health systems are acting early, transacting “before their options narrow.” 

Among the largest deals of the quarter, Chattanooga, Tenn.-based Erlanger Health System, a $1.6 billion organization, signed a nonbinding letter of intent to join Greenville, S.C.-based Prisma Health. The systems expect to sign a definitive agreement by the end of the year. 

Nonprofit organizations remained the most active buyers in the third quarter. Independent nonprofit systems were the acquirers in eight of the 16 deals.

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