Successfully Navigating the Strategic Partnering Process

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Client Profile:

A 200-bed acute care, sole community hospital, medical practice and affiliated provider organizations.


Our client is a successful and very progressive standalone health system and operates the only hospital in their county. The hospital has a very strong tie to the community having been founded in the 1940s by community members, some of whom have direct ties to today's Board of Directors.

As part of the System’s strategic planning process, management assessed the future healthcare needs of their service area and determined that alternative sources of capital or partnering were needed to support the vision for new and expanded facilities and services. The Board strongly endorsed the vision, but wanted to explore alternative options for financing before pursuing strategic partnering. We were retained to assist the Board with this exploration.

Over the course of several months, our consulting team, made up of i3 and members of an investment banking advisory firm with whom we have partnered several times, facilitated a board of directors process to consider various options for long-term financing of the Health System's strategic plan. As a result of the process, the board concluded that none of the other capital options were adequate and authorized our consulting team to organize and execute a local and regional solicitation of interest from potential strategic partners.

Based on responses to the solicitation, we assisted the Board in researching and evaluating the interested organizations, including providing assistance to the proposers to ensure their proposals were comprehensive.  Once the Board selected a short list of organizations from whom they wanted proposals, our team facilitated group meetings between the proposer teams and Health System executives to learn more and help assess chemistry with each of the proposers. Finally, we began a preliminary due diligence process to learn about each organization and their recent experiences with strategic partnering.

Each of the proposing organizations made formal presentations to Health System Board. We prepared an evaluation and comparison for the Board of each of the pieces of evidence obtained thus far: their expression of interest, their initial proposal, the results of the preliminary meetings among executives, formal presentations, financial modeling and assessments, and preliminary due diligence. Based on the evaluation and comparison, two finalists were selected for initial negotiations. Over several weeks, we met with the finalists and shared with them the Board’s feedback and areas of their proposals needing further enhancement. We shared each finalist’s responses with the Board. The Board then chose a final organization with whom to engage in a strategic partnering negotiation.

Within 4 months, the legal counsels representing both organizations, supported by our team and the documentation of our process and preliminary due diligence, crafted a memorandum of understanding between the two organizations.  Following final negotiations, due diligence and regulatory review, the organizations finalized and executed the strategic partnership.


The unanimous approval of the final strategic partnering agreement by the Health System Board came as a result of more than 18 months of their invested time. During that long process, we supported and facilitated their effort in assessing the true need, considering options and partners, evaluating those partners, selecting the best partner, and negotiating the best method and structure for successful partnering.