Paper Number

ICIS2025-2644

Paper Type

Complete

Abstract

The rise in U.S. hospital closures has significantly reduced access to healthcare services, particularly in rural areas. To avoid closure, financially distressed hospitals pursue mergers and acquisitions (M&A). However, M&A does not always ensure survival. Some acquirers preserve struggling hospitals, while others close them. This study investigates the factors influencing hospital survival following M&A, emphasizing the moderating roles of rural versus urban location and digitalization levels. Using data from U.S. hospitals between 2008 and 2017, we find that M&A generally reduced hospital closures, but the outcomes were contingent on the hypothesized moderators. M&A decreased closures among urban hospitals but increased closures among rural hospitals. Higher digitalization levels were associated with increased closure rates post-M&A. Target hospital’s high digitalization level creates major integration challenges, costs for the acquirer, and increases the target’s closure risk post-M&A. Hospital executives and policymakers can build on these insights to design strategies for minimizing hospital closures.

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21-Healthcare

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Dec 14th, 12:00 AM

The Effects of Mergers and Acquisitions on Survival of Target Hospitals in the United States: The Roles of Urban-Rural Location and Digitalization

The rise in U.S. hospital closures has significantly reduced access to healthcare services, particularly in rural areas. To avoid closure, financially distressed hospitals pursue mergers and acquisitions (M&A). However, M&A does not always ensure survival. Some acquirers preserve struggling hospitals, while others close them. This study investigates the factors influencing hospital survival following M&A, emphasizing the moderating roles of rural versus urban location and digitalization levels. Using data from U.S. hospitals between 2008 and 2017, we find that M&A generally reduced hospital closures, but the outcomes were contingent on the hypothesized moderators. M&A decreased closures among urban hospitals but increased closures among rural hospitals. Higher digitalization levels were associated with increased closure rates post-M&A. Target hospital’s high digitalization level creates major integration challenges, costs for the acquirer, and increases the target’s closure risk post-M&A. Hospital executives and policymakers can build on these insights to design strategies for minimizing hospital closures.

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