Several risks need to be monitored during health care industry M&As.

Risk management support often begins with conducting due diligence, said Madelyn Quattrone, senior risk management analyst with the ECRI Institute in Plymouth Meeting, Pa. This typically takes place prior to the acquisition, and involves researching the acquisition to understand its liability risk, its claims scenario, regulatory and compliance concerns, and its overall history.

Particularly true in acquiring a physician practice, but relevant in any health care merger, is the need to ensure appropriate underwriting practices and closing any gaps, said Todd Swanson, a principal in the business transactions department of Los Angeles-based Hooper, Lundy & Bookman Inc.

Comparing and meshing the merged entity's risk and safety culture is another priority, observers said.

Monitoring a facility's injectable medicine preparation and administration, on-site manipulation of medications and equipment reprocessing procedures ensure safe, healthy practices and can avoid catastrophic outcomes, said Dr. Joseph Perz, Atlanta-based epidemiologist and team leader with the Centers for Disease Control and Prevention. As needed, hiring an infection control professional to ensure appropriate procedures is a good measure.

A growing concern involves remote sites, said Ms. Quattrone. When a physician practice or health care entity includes remote sites, the ideal scenario includes an on-site assessment of risks and potential concerns. This cannot always be achieved; outside experts and consultants can help.

Likewise, outpatient facilities must be monitored as well, said Dr. Perz.

Compliance with fraud and abuse laws is often worth an extra look, since violations can be costly, said Mr. Swanson.

In short, hospital risk managers involved in M&As should be prepared for anything. According to Dr. Perz, there can be some “jaw-droppers” when it comes to acquiring an entity, mostly concerning what an organization may have done to remain operational.