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20 CFO / FINANCE Top 10 cities for healthcare M&A By Ayla Ellison T he top U.S. city for healthcare mergers and acquisitions is Bos- ton, according to an analysis by Mergermarket. e analysis includes transactions com- pleted between 2015 and 2018 by all types of healthcare organizations, in- cluding hospitals and other healthcare providers, pharmaceutical companies and medical equipment manufacturers. Below are the top 10 cities for health- care mergers and acquisitions, based on the analysis: 1. Boston — 93 deals 2. San Francisco — 86 deals 3. Dallas-Fort Worth (Texas) — 73 deals 4. Miami — 61 deals 5. Chicago — 57 deals 6. Los Angeles — 55 deals 7. Minneapolis — 50 deals 8. Nashville (Tenn.) — 50 deals 9. Atlanta — 50 deals 10. San Diego — 45 deals n CHI to sell health plan to Centene By Morgan Haefner E nglewood, Colo.-based Catholic Health Initiatives agreed to sell its health plan to Centene Corp., according to the Arkansas Democrat-Gazette. CHI said in June 2016 that it planned to exit the health insurance business and spin off its insurance subsidiary QualChoice Health. At the time, CHI reported QualCho- ice lost $97 million in the nine-month period ending March 31, 2016. QualChoice CEO Randall Crow and a Centene spokesperson confirmed to the Arkansas Democrat-Gazette Jan. 3 that the companies entered into a definitive agreement on the sale. The companies will remain independent until Arkansas In- surance Commissioner Allen Kerr finalizes and approves the deal. "There will be no changes to QualChoice operations in the near future as a result of the sale," Mr. Crow said in an email to the publication. "QualChoice members will still enjoy their current benefits and network of providers and pharmacies." QualChoice is Arkansas' third-largest health plan. Financial terms of the deal were not disclosed. n Size of organizations in mergers continues to grow, study finds By Leo Vartorella A s healthcare merger and acquisition activity grew in 2018, the average size of organizations partici- pating in mergers also grew, according to Kaufman Hall's "2018 M&A in Review: A New Healthcare Landscape Takes Shape" report. The report found that the average annual revenue of sell- ers, the smaller of the two organizations in a merger, was $409 million in 2018. This represents an average annual growth of 13.8 percent since 2008, when the average an- nual revenue of sellers was just over $100 million. "What we're seeing is a move toward strategic growth, driv- en in part by the need to acquire expertise and resourc- es to manage the industrywide changes facing hospitals and health systems," said Anu Singh, managing director at Kaufman Hall. "These include changes in payment and care delivery models and the push for greater value, but also the emergence of new competitors that bring signifi- cant capital resources and strong capabilities in both digi- tal technology and consumer experience to healthcare." n Kettering Health Network to sell $200M in bonds to fund expansion By Morgan Haefner D ayton, Ohio-based Kettering Health Network plans to sell $200 million in bonds to help finance upcoming expansion projects, according to The Bond Buyer. Ohio's Miami County will issue the bonds. Kettering will use about $100 million of the bond proceeds to cover expenses associated with a new hospital it plans to open this summer. Kettering will use the other half of the proceeds to refund bonds the system issued in 2009. Kettering is expected to generate $16.6 million in savings through the refund, according to the report. n