Paul Keckley writes in MedCity News:

“For providers, going big means building a fully integrated system of health that spans a region, provides preventive, chronic, acute and post-acute services seamlessly in a variety of retail, virtual, alternative and traditional settings. It’s an organization whose brand connotes value and the breadth of its services and programs extends well beyond those compensated through third-party payments. It takes full financial and clinical risk for its traditional programs and services under capitated agreements with multiple payers including its own plan. And its focus is total population health—from cradle to grave for the sick and the well. It connects health and human services and its investments in healthy communities and digital technologies to empower self-care are as critical to core operations structure as clinics, hospitals, ancillaries and post-acute programs.

“For healthcare providers, the transition to big is not without risk, but the greater risk is to be run over by the big’s {health systems}. There are certainly limits to going big: monopolies are carefully policed in our economy, but relative to the consolidation in other parts of healthcare, providers remain small and at a disadvantage.”