Healthcare Services Transactions Update – Q2 2026
Ankura is pleased to present an overview of healthcare services transactions announced or closed during Q2 2026 in the United States. Total transactions decreased by 22.9% in the second quarter of 2026 after increasing by 12.8% in the first quarter. Compared to Q2 2025, transaction volumes for Q2 2026 decreased by 12.0%.
Source: Scope Research Healthcare M&A Volume Database
Notable Transactions Announced or Closed in Q2[1]
- A consortium of investors agreed on June 10, 2026, to acquire a 40.0% interest in Gentiva for approximately $900 million, implying a total enterprise value of approximately $4.71 billion and a 2.3x price to revenue multiple. Gentiva is a U.S.-based, home-based care provider focused on hospice and related post-acute services, with FY 2025 revenue of approximately $2.05 billion. The implied enterprise value also reflects approximately $2.46 billion of debt outstanding at the time of the transaction.
- Jardine Matheson Holdings Limited agreed on May 25, 2026, to acquire I-MED Radiology Network for approximately AUD 3.4 billion, or US$2.4 billion, implying a 2.0x price to revenue multiple and an 11.5x price to EBITDA multiple. I-MED is an Australia-based diagnostic imaging provider, with LTM revenue of approximately US$1.23 billion and LTM EBITDA of approximately US$209 million, representing an EBITDA margin of approximately 17.0%.
- Knox Lane entered into a definitive agreement on May 6, 2026, to acquire Cross Country Healthcare, Inc. for $13.25 per share, representing an all-cash transaction valued at approximately $437 million and implying a 0.4x price to revenue multiple and a 16.3x price to EBITDA multiple. Cross Country Healthcare is a U.S.-based healthcare staffing provider focused on travel nurse and other workforce solutions, with FY 2025 revenue of approximately $1.05 billion and adjusted EBITDA of approximately $26.8 million, representing an EBITDA margin of approximately 2.5%. The company had previously been under offer in late 2024, and the fairness opinion projects significantly higher margins in the second half of 2026.
Key Observations
The second quarter of 2026 saw a decline in overall healthcare services transaction activity following the increase recorded in Q1. Total transactions decreased by 22.9% from the prior quarter and were down 12.0% compared to Q2 2025, reflecting a more selective deal environment as buyers continued to weigh interest rates, inflation, financing costs, reimbursement trends, and broader macroeconomic uncertainty.
Regulatory scrutiny of healthcare transactions remained elevated during Q2 2026, particularly for deals involving provider consolidation, physician practice roll-ups, management services organizations (MSOs), and private equity sponsorship. The Federal Trade Commission’s (FTC) Healthcare Task Force, launched in March 2026, continued to signal a coordinated federal focus on healthcare enforcement, competition, consumer protection, and emerging areas of concern across the sector.
State-level oversight also continued to expand in Q2, with regulators focused on private equity-backed healthcare transactions, MSO structures, roll-up strategies, and other affiliations that may not be reportable under traditional federal merger thresholds. These developments have increased diligence requirements and may lengthen transaction timelines for certain healthcare services deals.
As shown in the figures below, recent healthcare acquisitions continue to be concentrated across a select group of sectors. In Q2 2026, Professional Services,[2] Physician Groups, and Outsourced Services[2] accounted for 259 transactions, or 57.8% of adjusted transaction volume. Professional Services remained the most active sector with 116 announced transactions, followed by Physician Groups with 91 transactions and Outsourced Services with 52 transactions.
Professional Services transaction activity decreased from 145 transactions in Q1 2026 to 116 transactions in Q2 2026, representing a 20.0% decline. Despite the decrease, the sector continued to represent the largest share of total healthcare services deal activity, supported by ongoing interest in areas such as healthcare consulting, outsourced administrative services, and other professional services platforms.
Physician Groups activity also decreased in Q2 2026, declining from 147 transactions in Q1 2026 to 91 transactions in Q2 2026. The decrease represented the largest decline among the most active sectors, though Physician Groups remained the second-largest category by transaction count and continued to reflect buyer interest across physician practice management and specialty provider platforms.
Outsourced Services declined from 74 transactions in Q1 2026 to 52 transactions in Q2 2026, while Behavioral Health decreased from 58 transactions to 37 transactions over the same period. The most notable increases were in Pharmacy / Infusion, which increased from 12 transactions to 25 transactions, and Medical Transportation, which increased from no reported transactions in Q1 2026 to five transactions in Q2 2026.
Overall adjusted healthcare services transaction volume decreased from 581 transactions in Q1 2026 to 448 transactions in Q2 2026, representing a 22.8% decline. Compared to Q2 2025, adjusted transaction volume decreased 11.9%, reflecting a softer quarter relative to both the prior quarter and the same period in the prior year.
The decline in Q2 2026 activity was likely driven by several factors, including elevated financing costs, continued uncertainty around the timing and magnitude of interest rate cuts, and more cautious buyer underwriting following the rebound in Q1. Healthcare-specific pressures, including reimbursement uncertainty, labor cost inflation, margin compression, and heightened federal and state regulatory scrutiny of provider consolidation and private equity-backed transactions, also likely contributed to longer diligence periods and a more selective market for new platform investments.
Future Outlook
Looking ahead to the remainder of 2026, healthcare investors will continue to monitor interest rates, inflation, reimbursement trends, operating performance, and regulatory developments. The Federal Reserve maintained the federal funds target range at 3.50% to 3.75% in June, while updated projections indicated inflation was expected to remain above the 2% target through 2026. These conditions may continue to support disciplined investment activity, particularly in assets with resilient demand, strong market positions, and identifiable opportunities for margin improvement.
Geopolitical uncertainty involving Iran may also affect the transaction environment. The Federal Reserve’s July 2026 meeting minutes noted that renewed escalation in the Middle East contributed to higher oil prices and uncertainty surrounding inflation, supply chains, interest rates, and financial markets. A prolonged conflict could increase inflationary pressure. Continued volatility and elevated borrowing costs may therefore affect transaction timing, capital structures, and projected financial performance.
Healthcare policy and enforcement priorities under the Trump administration will remain important considerations. The FTC’s Healthcare Task Force indicates that federal regulators will continue reviewing transactions and commercial arrangements involving consolidation, competing facilities, physician practices, and private equity backed platforms. Recent settlements also suggest that certain transactions may proceed when structural remedies address competition concerns.
State oversight is also expanding, particularly for transactions involving private equity sponsors and management services organizations. Additional disclosures, longer notice periods, and higher filing costs may affect diligence, transaction structures, and closing timelines.
Overall, activity may improve from the lower Q2 level as strategic buyers and private equity investors pursue quality assets and targeted acquisitions. Interest will likely favor businesses with stable reimbursement, strong market positions, scalable operations, and margin improvement opportunities. Businesses facing greater regulation, labor, reimbursement, or financing uncertainty may experience longer diligence periods and wider valuation differences.
About Ankura Healthcare Transaction Advisory Services
Healthcare transactions are inherently complex. With deep industry experience, Ankura delivers insights to make informed investment decisions in mergers, acquisitions, and partnerships.
Ankura’s Healthcare Transaction Advisory team is deeply rooted in the healthcare sector, leveraging extensive industry knowledge and expertise to anticipate critical financial accounting aspects of transactions while also understanding the operational drivers. This enables us to proactively address critical financial accounting aspects and operational drivers of transactions.
What sets us apart is the collaboration between our financial accounting due diligence experts and Ankura’s specialized teams in healthcare valuation, healthcare operations, tax, information technology, commercial strategies, and human capital. This collaboration ensures a seamless, integrated reporting process to you, combining diverse expertise to provide a holistic view of every transaction. Our approach guarantees that you receive nuanced, actionable insights in a unified and strategic manner.
With senior deal professionals engaged in every transaction phase, we provide immediate updates on significant deal factors and a dedicated analysis of any critical issues, ensuring a thorough understanding and resolution of underlying concerns.
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References
[1] Scope Research Healthcare M&A Volume Database, published by Scope Research; Capital IQ
[2] The Professional Services sector includes dentistry, physical therapy, physician practices, urgent care, veterinary, and other clinics. The Outsourced Services sector includes billing, revenue cycle, management services organizations, marketing, staffing, and other services commonly outsourced by medical practices.
© Copyright 2026. The views expressed herein are those of the author(s) and not necessarily the views of Ankura Consulting Group, LLC, its management, its subsidiaries, its affiliates, or its other professionals. Ankura is not a law firm and cannot provide legal advice.
