title: Mergers and acquisitions in Western European health care: exploring the role of financial services organizations.
abstract: Recent policy developments in Western European health care - for example in the Netherlands - aim to enhance efficiency and curb public expenditures by strengthening the role of private sector. Mergers and acquisitions (M&As) play an important role in this respect. This article presents an analysis of 1606 acquisition deals targeting health care provider organizations in Western Europe between 1990 and 2009. We particularly investigate the role of financial services organisations as acquirers. Our analysis highlights (a) a rise of M&As in Western Europe since 2000, (b) an increase of M&As with financial service organisations acting as acquirer in absolute terms, and (c) a dominant role of the latter type of M&As in cross-border deals. To explain these developments, we make a distinction between an integration and a diversification rationale for M&As and we argue that the deals with financial services organisations in the role of acquirer are driven by a diversification rationale. We then provide arguments why health care, from the acquirer's perspective, can be considered as an interesting target in a diversification strategy and we advance reasons why health care providers may welcome this development. Although caution in drawing conclusions is needed, our findings suggest a penetration of private capital into health care provision that may be interpreted as a specific form of privatisation. Furthermore, they point to a rising internationalisation of health care. Both findings may entail far-reaching implications for health care, as they may induce both cultural privatisation and cultural internationalisation.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Duboisdomein 30, Post Box 6200 MD, Maastricht, The Netherlands. federica.angeli@maastrichtuniversity.nl
authors.forename: Federica
authors.initials: F
authors.lastname: Angeli
authors.forename: Hans
authors.initials: H
authors.lastname: Maarse
mesh_terms: D002202:Capital Financing / Q000191:economics / Q000458:organization & administration; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D005060:Europe; D019981:Health Care Sector / Q000191:economics / Q000458:organization & administration; D006273:Health Facility Merger / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006282:Health Personnel / Q000191:economics / Q000458:organization & administration; D017149:Private Sector / Q000191:economics / Q000458:organization & administration; D012306:Risk