The Bond Buyer’s 501(c)3 Super Conference was held on September 20, 2010 at the Hilton New York in New York City.  This year’s event brought together investors, finance professionals and executives from hospitals, health systems, academic medical centers, higher education institutions, performing arts centers, rating agencies and finance firms from across the country to network and share thoughts about the challenges nonprofits face today in accessing the capital markets.  Of course, health care reform was on everyone’s mind.  Several speakers discussed the impact of reform on the health care finance industry and the health systems that need to finance their strategic projects as these systems reorganize and prepare for the changes brought about by health care reform and the aging population.
Some are taking a wait and see approach and not making any big moves until the dust settles after the fall election.  Most believe, however, that no matter what happens in November, many of the payment and delivery reforms in PPACA will stick.  Iain Briggs, FTI Healthcare, organized a panel to discuss recent merger and acquisition activity in the hospital and health system industry.  Everyone on the panel agreed that among the winners will be those systems that can grow and deliver high quality care while at the same time effectively lowering operating costs.
While recent activity has involved for profit acquisitions and combinations with nonprofit systems, many predict that we will see an uptick in acquisitions and other forms of regional affiliations between nonprofits.  Nonprofits still provide approximately 85% of the health care in the United States, so nonprofits will necessarily be a player in the post-reform landscape.  How nonprofits and for profits partner to develop new delivery systems highlights several important and challenging tax, charitable trust and anti-trust legal questions that will need to be addressed by lawyers and regulators alike.  Overall, the finance industry representatives agree that health care does need reformed in this country, but with the uncertainty of the pending elections, there is still much debate about what reform will ultimately look like.