The merger of Advocate Health Care in Northern Illinois and Aurora Health Care in Wisconsin into Aurora Health advocate is an example of consolidation. The agreement, reached on April 2, 2018, brought together two major health systems in a super-parent model. Basically, the two systems — now with 27 hospitals and $11 billion in revenue — have created a new parent system with a consolidated management team led by two co-CEOs. Norton Healthcare`s 263-bed Children`s Hospital in Louisville and Kentucky Children`s Hospital at the University of Kentucky HealthCare (Lexington) have a joint enterprise agreement. Hospitals remain independent, with separate statutes, medical personnel and rules, according to a Memorandum of Understanding. Officials at both hospitals will review the partnership plan over the next three to four months. “Ultimately, the IRS will assess the facts and circumstances of the JOA/JOC structure to ensure that the YCW has sufficient functional and financial control to establish its treatment as the parent company of affiliated hospitals,” the guide states. 3. Problems of agreement: the JOA/JOC structures also raise problems of agreements because they involve the cooperation of two or more hospitals, often competing, in the conduct of activities that each hospital has been able to carry out separately. Although the JOA/JOC structure involves risk sharing, economies of scale or efficiencies in integration, the agreement is generally authorized by agreement law when the following criteria are met: Mission Health continues to be managed locally, but HCA operations, access to capital, clinical studies, research and other areas are integrated.
Under the agreement, almost all mission health facilities will be part of HCA Healthcare, but continue to carry the health mission brand. As an interesting further turning point, HCA and Mission have agreed to invest $25 million in an innovation fund that will invest in companies that innovate in health care, benefiting the people of West North Carolina. Transactions collapse into three elements: consolidation, convergence and direction. Consolidation transactions are classic control/change models. They may also include joint ventures and joint enterprise agreements. Hospitals, which are looking for partners but want to maintain an appearance of autonomy, have evolved into common enterprise agreements. 3) issues of cartels and abuse of dominance. Because JOAs may include two or more competing hospitals in collaborative relationships, they must address all concerns about cartels and abuse of dominance. Thus, both parties must ensure that the joA structure “does not impose inappropriate incidental restrictions on hospital parties,” the guide states. The members of the JOA are characterized by the fact that the hospital parties retain their identities and boards of directors, as well as a degree of autonomy, although considerable administrative and financial powers are transferred to the YCW. The JOA itself will outline the proposed legal relationship between the parties; Address governance, management and financial issues and contains termination provisions.