

M&A in Healthcare with John Palusci
Jul 21, 2025
John Palusci, the former VP of Transformation and Strategic Finance at BAYADA, shares his remarkable journey from IT to M&A leadership in healthcare. He discusses building a repeatable, buyer-led M&A engine in a nonprofit setup, focusing on mission alignment and long-term value. Key insights include strategies for managing integration risk, refining deal sourcing, and navigating cashless acquisitions. He emphasizes the importance of mentorship, effective communication, and due diligence in successfully merging organizations in a highly regulated industry.
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Learning M&A in Joint Ventures
- John learned most of his M&A skills through six joint ventures with hospital systems at Bayada.
- He experienced the full cycle, from valuation to living with the deal results afterwards.
Mission Drives Nonprofit Transition
- Transitioning Bayada from for-profit to nonprofit was to ensure its mission lasted beyond the founder's involvement.
- The nonprofit structure imposed discipline and an independent board to safeguard mission alignment.
Nonprofit M&A Requires Mission Focus
- Being a nonprofit forces strict mission alignment in M&A and limits buying outside core competencies.
- Nonprofits often have a longer investment horizon, focusing on owning assets forever rather than flipping them.