Health care sector mergers and acquisitions decrease equity and access.

Health care mergers and acquisitions (M&A) can threaten health care quality and access because they may negatively impact market competition and affordability for consumers. To ensure that health care M&A align with the state’s health care goals—including maintaining and expanding equitable access for all residents, providing reliable health care facilities, and ensuring that every community has the health workforce it needs—California requires that organizations submit material change transaction notices.  

The Office of Health Care Affordability in California’s Department of Health Care Access and Information sought support in evaluating these submissions to ensure that they meet the criteria for significant impact on market competition, spending target compliance, or affordability.

NORC is using mixed methods to evaluate health care M&A submissions.

California’s Office of Health Care Affordability commissioned NORC to review specific financial and transaction documents submitted to it by the entities involved in the M&A process. We are using the following methods to assess the financial and quality-of-care impact that any given merger may have on California’s health care landscape:  

• Qualitative review of documents submitted by parties to the transaction
• Quantitative analysis of various publicly available data sources to quantify market impacts of the transaction

For each M&A transaction under review, we create an in-depth report detailing financial or legal concerns and other factors including level of impact on health care access or quality.