Despite regulatory headwinds, health systems are starting to engage in more M&A. According to the most recent quarterly report by Kaufman Hall, 20 hospital and health system M&A deals were reported in the first quarter of 2024, making it the busiest Q1 since 2020 (although still ~30% below the pre-pandemic average). Four of the announced transactions were “mega mergers,” with the smaller party having annual revenues greater than $1B.