Last updated: November 8, 2026
Hospital M&A and valuation, by the numbers
Hospital transaction counts, transacted revenue, the distressed-deal share, operating margins, the count of American hospitals, closures, and the multiples buyers actually pay — from published sources.
Three different kinds of number sit behind this name, and they must not be mixed. The first kind measures deal flow: how many hospitals change hands, and for how much revenue. The second kind measures the pressure that drives the flow: operating margins, the share of hospitals losing money, and the share of deals involving a distressed party. The third kind measures what buyers pay: the EBITDA and revenue multiples that turn a hospital's earnings into a price. The first kind tells a reader how busy the market is. The second tells a reader why. The third tells a reader what the work of valuation is worth.
What the latest numbers show is a market that stalled in 2025 and came back hard in 2026: deal counts fell to their lowest since Kaufman Hall began tracking in 2011, transacted revenue fell to its lowest since 2018, and distress reached a record share — then the first three quarters of 2026 produced more deals than all of 2025, led by divestitures and mega mergers rather than by distress alone.
The figures
| Figure | Value | Trend vs prior period | Source |
|---|---|---|---|
| Hospital and health system transactions announced, 2025 | 46 | ▼ Down Prior: 72 in 2024; lowest annual count since Kaufman Hall began tracking in 2011 | Healthcare Dive, Hospital M&A declined in 2025 (January 20, 2026); Fierce Healthcare (January 16, 2026) |
| Total transacted revenue, 2025 | $18.5 billion | ▼ Down Prior: $39.7 billion in 2024; lowest level since Kaufman Hall began tracking the data in 2018 | HealthLeaders Media (January 2026); Fierce Healthcare (January 16, 2026) |
| Share of deals involving a financially distressed party, 2025 | 43.5% | ▲ Up Prior: 30.6% in 2024, 27.7% in 2023, 15% in 2022 — a record high, and the third consecutive annual increase | Healthcare Dive (January 20, 2026); Becker's Hospital Review (January 15, 2026) |
| Average annual revenue of the smaller party in distressed deals, 2025 | $345 million | ● Baseline Distress reached mid-sized and larger systems, not only small community hospitals | Healthcare Dive (January 20, 2026) |
| Hospital transactions announced, Q1 2026 | 22 deals; $14.5 billion transacted revenue | ▲ Up Highest first-quarter deal count since 2020 and the highest Q1 transacted revenue in recent years; average seller size $657 million, the second-highest since 2018 | Becker's Hospital Review (April 9, 2026); Health Capital Topics (April 2026) |
| Divestitures, Q1 2026 | 15 of 22 deals (68%) | ▲ Up Prior: divestitures were 45.6% of all 2025 transactions; only 4 of the 22 Q1 deals (18%) involved a distressed seller | Health Capital Topics (April 2026); HealthLeaders Media (April 2026) |
| Mega mergers, Q1 2026 | 3 of 22 deals | ● Baseline Smaller party above $1 billion in annual revenue; largest was Sutter Health and Allina Health, announced March 17, 2026, a combined $26 billion entity | Becker's Hospital Review (April 9, 2026) |
| Hospital transactions announced, Q2 2026 | 18 deals; $7.7 billion transacted revenue | ▲ Up Prior: 8 deals and $1.4 billion in Q2 2025, the lowest Q2 total since 2018; only 3 of the 18 Q2 2026 deals involved a distressed seller | Healthcare Dive (July 13, 2026) |
| Hospital transactions announced, Q3 2026 | 16 deals; $8.2 billion transacted revenue | ▲ Up 56 deals through Q3 2026 versus 46 in all of 2025; average seller $586 million, up from $401 million in Q3 2025; two mega mergers in the quarter | Becker's Hospital Review (October 14, 2026); Fierce Healthcare (October 14, 2026) |
| Median hospital operating margin, August 2026 | 1.8% (monthly); 2.5% calendar-year-to-date | ▼ Down Prior: 3.8% in July and 5.6% in June 2026; August was the lowest monthly median since February; based on more than 1,300 hospitals | Becker's Hospital Review (October 22, 2026); Fierce Healthcare (October 14, 2026) |
| Share of U.S. hospitals operating at a loss, August 2026 | Roughly 43% | ▲ Up Prior: about 33% before the COVID-19 pandemic; bad debt and charity care rose to 13% of costs in 2026 | Becker's Hospital Review (October 22, 2026) |
| Total number of U.S. hospitals, 2026 | 6,100 | ● Flat Prior: 6,093 in the 2025 edition (2023 survey); data from the 2024 AHA Annual Survey, covering more than 6,200 hospitals and 400 health systems | American Hospital Association, Fast Facts on U.S. Hospitals, 2026 (updated February 2026) |
| Hospital closures and openings, 2010–2025 | 432 closed; 216 opened; net −216 hospitals and −24,399 beds | ● Baseline Harvard T.H. Chan School of Public Health study of acute-care hospitals, using AHA survey data; closure rate rose about 4% a year while openings fell about 3% | Advisory Board (October 13, 2026) |
| Hospital EBITDA multiples, 2026 | 6.3x ($1–3M EBITDA); 8.2x ($3–5M); 9.7x ($5–10M) | ● Baseline Median healthcare-services EV/EBITDA about 11.5x in 2026, down from 14.5x the prior year; figures are for private healthcare companies, educational use | FOCUS Investment Banking, Healthcare EBITDA Multiples: 2026 Dashboard |
| Hospital revenue multiples, 2026 | 1.0x ($1–5M revenue); 1.5x ($6–10M); 2.0x ($10–50M) | ● Baseline Transactions above $10M in revenue typically attract institutional buyers or strategic health systems | FOCUS Investment Banking, Healthcare EBITDA Multiples: 2026 Dashboard |
| Private-equity-owned U.S. hospitals, April 2025 | 488 | ● Baseline Private Equity Stakeholder Project tracker; largest owners include Apollo Global Management (Lifepoint Health, ScionHealth) and Welsh, Carson, Anderson & Stowe (Select Medical, Emerus) | Private Equity Stakeholder Project, Private Equity Hospital Tracker (October 2026) |
How to read these numbers
Included: Kaufman Hall's quarterly and annual hospital transaction counts and transacted revenue, as reported by Becker's Hospital Review, Healthcare Dive, Fierce Healthcare, HealthLeaders Media, and Health Capital Topics; Kaufman Hall's National Hospital Flash Report operating-margin figures, as reported by Becker's; the American Hospital Association's hospital counts; a Harvard study of hospital closures; FOCUS Investment Banking's published healthcare multiples; and the Private Equity Stakeholder Project's hospital tracker. Excluded: any valuation multiple presented without its EBITDA or revenue band; any single hospital's sale price presented as a market multiple; and any forecast for a year not yet complete.
Kaufman Hall's "transacted revenue" is the annual revenue of the smaller party in each announced transaction, not the price paid — the two are different, and this page does not treat them as the same. Multiples from FOCUS are published ranges for private healthcare companies, not transaction prices for any specific hospital. Forecasts are labeled as forecasts, not actuals.
Disclaimer: Figures on this page are aggregated public estimates assembled for information only. They are not investment advice, legal advice, or a professional opinion on any specific case, claim, project, or purchase. Original reporting and the underlying surveys remain the work of the sources linked above; this page summarizes their published figures with attribution and adds no proprietary dataset.
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Changelog
- November 8, 2026: Initial edition — Kaufman Hall 2025 year-end and Q1–Q3 2026 transaction figures, operating margins, AHA hospital counts, closure data, FOCUS valuation multiples, and the private-equity hospital count established.