Over the last decade, the United States (US) hospital industry has become increasingly consolidated through the formation of multi-hospital health systems and networks and the legal merger of institutions under a single license. In relation to the former, health networks are strategic alliances or contractual affiliations of hospitals, in which affiliated institutions retain their individual ownership. Health systems, on the other hand, typically own and operate a core set of hospitals that offer an array of services and products. In many markets across the country, there are now only three to five hospital organizations in operation, after one accounts for their combined ownership or network affiliations.

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