The promise of the brand: How health system leaders are guiding the transition to health services integration

Many regional (and national) not-for-profit community health systems in the United States were formed from asset mergers. By merging, community hospitals exchanged independence and certain rights of decision making for enhanced access to future investment capital, better payer contracting leverage, centralized corporate support services, and enhanced security in uncertain markets ahead. These hospitals often retained a local governing board; a CEO who reported to that board; and a few areas of purview typically relating to the designs and methods for affiliating and integrating with local physicians, clinical services and programs offered, credentialing and privileging of members of the independent medical staff, and-to a certain extent-definitions of quality and efficiency of the care provided.