The acquisition of PresenceвЂ™s 12 hospitals should be a good fit for Ascension as it seeks to advance the AMITA Health partnership and gain more ground in Illinois. How do you see AscensionвЂ™s larger AMITA presence competing and faring with other systems in the Chicago metropolitan area, including Advocate, Northwestern, Rush and University of Chicago Medicine? Several others could be a target for absorption, especially if they exist in semi-remote markets, align on mission with the Catholic system or struggle to obtain favorable networks via the payers. This has an interesting impact on the Chicago and North Indiana hospital markets. Such dis-synergies can become a taxing problem for current and future acquisitions. Ascension already faces вЂ“ like many hospital systems вЂ“ a proliferation of applications doing the same thing. This could potentially lead to accumulating dis-synergies. Narrow integration of Presence Senior Care unit is interesting. In fact, efficiency can worsen due to size. However, like most hospitals, efficiency isnвЂ™t the top priority. This is another acquisition in a long spree of acquisitions for Ascension, showing that Ascension is committed to size. What about operational redundancies, in terms of Supply Chain? Or is it too early to talk about centralization and standardization efforts? I presume Presence facilities will be using AscensionвЂ™s GPO The Resource Group? What changes can we anticipate? There will be a lot of complexity in PresenceвЂ™s operations over the next several years as they untangle one set of units and integrate into another organization. Presence has been busy with M&A activity and is already dealing with divesting two hospitals in Illinois. This allows providers and employees to focus on providing care versus wondering about the future of the organization. More broadly, adding Presence to the AMITA Health joint venture should allow Presence to take advantage of investments that AMITA has already made in back-office operations (e.g., technology), which would allow Presence to improve their balance sheet.ДЄ joint venture versus a stock deal avoids the complex regulatory process, which could drag out for 18+ months. SHAIKH: ItвЂ™s not clear whether Presence Health will take on the AMITA branding yet, though this will likely be answered as the deal closes. HPN: Will Presence Health as a brand name go away, replaced by AMITA Health branding? Or will there be some kind of co-branding? With the deal reported in a variety of media outlets, including Healthcare Purchasing NewsвЂ™ online Daily Update, HPN Senior Editor Rick Dana Barlow asked for general market insights from Munzoor Shaikh, Director, West MonroeвЂ™s healthcare practice. AMITA Health represents a Chicago-based joint venture between AscensionвЂ™s Alexian Brothers Health System and Adventist Midwest Health. Five months later, Presence decided to renew with Premier and join PremierвЂ™s Catholic Contracting Group (CCG), which formed in 2005 around committed supply and service contracts involving $2.4 billion in annual purchasing volume at that time.Д«y joining Ascension, which is fusing Presence with its AMITA Health unit, Presence likely will shift its purchasing volume over time to AscensionвЂ™s own group purchasing organization The Resource Group. At that time, Resurrection had been a member of Premier Inc. Presence debuted in November 2011 from the merger of Resurrection Health Care and Provena Health. Louis-based Ascension Health, the faith-based Catholic health system, solidified its presence in the Chicago metropolitan area and state of Illinois by agreeing to acquire Presence Health and its 12 facilities.

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