That’s changing, as more hospital-centric health care systems add so-called hospital outpatient departments (HOPDs) that look and act much like traditional physician-owned clinics.An Accenture report this year noted that “the era of the independent physician that many adults grew up with is swiftly coming to an end.” In 2000, 57 percent of physicians practiced independently, outside a larger health care system.It should almost come with its own dramatic background music. The combining of two or more previously separate businesses is in full force among health care providers, with large numbers of mergers and acquisitions as providers seek both horizontal breadth and vertical integration to offer the most care services to the most people.Earlier this decade, Medcenter One, based in Bismarck, N.(Full disclosure: Brainerd is the former chair of the board of directors for the Federal Reserve Bank of Minneapolis.) Specialists are also targets for vertical consolidation and integration.According to a national survey by the American College of Cardiology, the share of cardiovascular practices that are owned by physicians dropped from 59 percent to 36 percent from 2007 to 2012.
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It’s often feared, at least until one becomes familiar with it, or its alternative.But consolidation has also morphed into many different structural and legal forms that stop short of traditional mergers and acquisitions but achieve strategic objectives for both organizations.Consolidation, in its many shapes, sizes and arrangements, appears to be accelerating as health care organizations look to achieve greater scale to address a dizzying array of market and government pressures.Reimbursement policies, technology, regulations, capital needs, shifts in patient care and other factors have combined to create a state of flux in health care that is making organizational independence more and more difficult.