Peter Attwater, Managing Director Health systems continue to pursue mergers, acquisitions, and member substitutions to expand access, enhance capabilities, and achieve scale that reduces administrative and fixed costs. While organizations devote substantial effort to evaluating potential partners, conducting due diligence, and preparing for Day 1, far fewer apply the same level of discipline to what happens afterward. In our work across the country, we see a common pattern: o

Shawn Fitzgibbon, Managing Director, BDC Advisors 2026 is shaping up to be one of the most financially volatile years health systems have faced in over a decade. A convergence of policy changes, enrollment disruption, and rising employer-sponsored insurance costs is poised to materially increase revenue risk, bad debt, and patient affordability challenges — often faster than organizations can react. For health system leaders, the question is no longer whether these pressures

Peter Attwater, Managing Director AMCs are at a pivotal moment in their evolution. To sustain their tripartite mission of clinical care, research, and education, leaders must proactively embrace mergers and acquisitions as a strategic necessity. It is essential to move beyond traditional growth models and recognize that M&A offers a faster, more cost-effective path to expanding capacity, protecting academic and research missions, and reinforcing the safety net for vulnerable

Alexandra Criscione, Director Jamie Hanrahan, Principal Health systems often assume that owning a health plan will automatically drive margin, market control, or population health success. But the truth is more complex. A provider-sponsored health plan can be a powerful strategic lever or a costly distraction, depending on how clearly it’s aligned with health system goals. Why This Matters Now Healthcare margins are thin, payers are consolidating, and capital is scarce. Every

Shawn Fitzgibbon, Managing Director, BDC Advisors With shared analytics and a longer-term perspective, health systems and payers have a unique opportunity to transform local and regional markets. Are you ready to break the cycle of unit cost battles, compromised short-term solutions, resulting in consumer dissatisfaction—and disrupt your market to capture a greater share with a committed partner? Success for payers and providers rests on establishing long-term predictable and