The final numbers are in regarding merger and acquisition activity in 2018, and based on PricewaterhouseCooper's latest report, it was a banner year. Volume was up 14.4 percent from 2017 to 2018.
That's good for 1,182 mergers and acquisitions overall, driven by a couple of big quarters which saw more than 300 such transactions apiece.
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While the total volume of M&A deals was exceptionally high, the value of those deals dipped 31.4 percent from the previous year, landing at $121.5 billion. That's still a significant amount, topping 2015 and 2016 by 1.4 and 1.7 times, respectively.
Long-term care accounted for a significant chunk of M&A activity, continuing a trend, starting in 2015, of the sub-sector comprising 30 percent of total deal volume. At least 300 transactions per year have happened in that space. In 2018, that number topped 400.
While traditional providers such as hospitals, home health agencies and physician groups tend to dominate M&A activity, nontraditional providers are increasingly opting to acquire, notably when Amazon acquired PillPack for about $1 billion over the summer.
The Cigna-Express Scripts deal qualified as a nontraditional M&A deal, and at $67 billion, it was one of three so-called "megadeals" to occur in 2018 -- the others being the $9.9 billion deal between KKR & Co. and Envision Healthcare Corporation; and the $5.6 billion RCCH HealthCare Partners/LifePoint Health deal.
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Behavioral care saw the highest growth in volume at 52.6 percent, and in value at 141.9 percent. Rehabilitation saw declines of 20.4 and 87 percent, respectively. The value of managed care deals fell by almost 97 percent.
A PwC temperature check during the third quarter of 2018 was consistent with the year's final numbers, showing high volume but declining value.
A big part of the reason mergers and acquisitions in healthcare have been accumulating at a mighty clip over the past several years is scale. Consolidation helps healthcare organizations increase the scale of their business and retain, or even increase, their market share.
PwC expects M&A activity to continue trending upward over the course of this year.