While we can hope an ACA repeal comes with a replacement – a Republican health care reform 2.0 plan – many in the health care M&A community have been asking, what effect will an ACA repeal have on the health care M&A market place?
A little hope comes with what I am about to say, but, an ACA repeal likely won’t create a serious downturn in health care M&A activity. The largest reason for this is that both sides of the aisle continue to seemingly agree on some fundamental concepts when it comes to health care – we need to incentivize better care for less money and use technology and big data to get us there.
Shifts in our payer models from fee for service to value based purchasing that rewards quality and efficiency and punishes waste and inefficiency are almost universally accepted by government policy makers and the private sector. These shifts were occurring pre-ACA and don’t appear to be in jeopardy if we get to a post-ACA world. Don’t forget that the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), the law which transitions mostly outpatient providers toward a value-based payment system, was pretty recently passed with significant bipartisan support. In the new health care “system” efficiency and quality are rewarded. These new fundamentals are not going away and continue to be the catalyst for investment in providers, suppliers, ancillary businesses and technology vendors positioned to take advantage of these fundamentals. The businesses focused on these new fundamentals are poised for growth and represent significant investment opportunities for private equity and strategic acquirers.
As a result, interest in consolidation, integration, technology-enabled solutions and big data usage is going to continue. Investment by private equity firms and strategic acquirers in 2017 will remain at a good pace given that health care policy focus points for both the Republicans and Democrats include delivering efficient and quality care through value based purchasing and technology, irrespective of whether or not ACA is repealed.
With an understanding of the new fundamentals and keeping a close watch on health care policy changes, investors are likely to find a great deal of interesting and innovative opportunities in health care M&A in 2017 and beyond.