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The Impact of Consolidation in the Healthcare Space

Host David Kemp and M&A Healthcare Advisors partner Andre Ulloa examine how consolidation is reshaping the healthcare industry, discussing the pressures driving mergers and acquisitions and their downstream effects on patients, providers, and market competition. The conversation highlights how M&A activity is altering the competitive landscape and access to care. Both speakers explore strategic considerations for organizations operating in an increasingly consolidated environment.

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By David Kemp · · Andre UlloaDavid KempHealthcare ChallengesHighway to Health
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Key takeaways

01

Healthcare market consolidation is accelerating, driven by mounting financial and competitive pressures on providers.

02

M&A activity significantly impacts both patient access to care and the ability of providers to compete for resources.

03

Strategic advisory expertise is increasingly critical for healthcare organizations navigating mergers and acquisitions.

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Highway to Health host David Kemp explores the impact of consolidation in the Healthcare Space with insights from Andre Ulloa, Partner and Executive Advisor at M&A Healthcare Advisors. They discuss the challenges of market pressures and the impact of M&A activities on patient and provider communities.

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About the author

David Kemp
David KempHealthcare Lead

With experience in coaching college basketball, supporting large healthcare systems through ICD-10, to now leading the healthcare vertical at MarketScale, David enjoys the journey. Craving knowledge is one of David's core values, and he has the opportunity to learn from some of the best as host of the Highway to Health podcast series.

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More Healthcare Insights

Denials get a queue, underpayments just look like paid claims

Denials get a queue, underpayments just look like paid claims

Underpayments in healthcare revenue cycle operations lack the visibility of denied claims because they don't trigger alerts or queue workflows. Without dedicated ownership and line-level verification against contract terms, paid claims that fall short of their contractual amount pass through undetected.

  • 01Denial workflows activate on rejection events, but underpayments produce no event, leaving paid claims unverified by default.
  • 02The speaker says many provider groups lack line-level contract intelligence to check each paid line against the applicable terms.
  • 03Payment received and payment checked are separate tasks: one verifies acceptance, the other verifies correctness—and the second often has no assigned owner.

Nov 6, 2026

A zero-paid claim line is not automatically an underpayment

A zero-paid claim line is not automatically an underpayment

A zero payment on a claim line isn't automatically an underpayment; contract terms, particularly packaging rules, determine whether zero is correct. Chasing unsupported findings damages credibility with payers and weakens the position of legitimate disputes, so revenue cycle teams must verify the full contract terms and effective dates before treating any payment difference as a finding.

  • 01When a contract packages add-ons into the primary procedure, the add-on line may legitimately show zero payment because it is folded into the primary procedure reimbursement.
  • 02Pursuing payment differences that lack contract support burns credibility with payers and can weaken the team’s position on later disputes, including valid ones.
  • 03Always verify the complete contract terms, fee schedules, carve-outs, amendments, and the specific version in effect on the date of service before treating a payment variance as a recoverable underpayment.

Nov 6, 2026

A clean, paid, closed claim can still be short of the contract

A clean, paid, closed claim can still be short of the contract

Practices can receive payment on closed, clean claims that still fall short of negotiated contract amounts because billing ends at coding, submission and posting, while no role owns checking whether payer payments match fee schedules. The speaker argues that contract-level payment review is a separate, complementary function that compares closed claims to contract terms and, run continuously, helps surface shortfalls in time to act within timely filing windows.

  • 01Correctly coded and billed healthcare claims can still result in underpayment.
  • 02Practices should review closed-claim payments against contract terms to spot underpayments.
  • 03Discrepancies in claim payments can persist despite adherence to billing protocols.

Nov 6, 2026

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About the Experts

David Kemp
David Kemp

Host, Highway to Health

David Kemp is the host of Highway to Health, a MarketScale show exploring the future of healthcare through conversations with industry innovators and experts. He covers topics ranging from market consolidation and M&A activity to patient care and provider challenges. Kemp brings together thought leaders to examine the forces reshaping the healthcare landscape.

AU
Andre Ulloa

Partner and Executive Advisor

M&A Healthcare Advisors

Andre Ulloa is a Partner and Executive Advisor at M&A Healthcare Advisors, a firm specializing in mergers and acquisitions within the healthcare sector. He advises healthcare organizations navigating market consolidation, providing strategic guidance on M&A activity and its effects on patient and provider communities.

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