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Unlike acquisitions of a different era, much of this activity is centered on linkages in disparate markets.In other words, it's not the traditional play to gain market share in a particular small area that is driving this trend.

You borrow enough money to pay off all your current debts and owe money to just one lender.

For one thing, government regulators are watching closely and often are breaking up even completed mergers that they deem have local or regional monopoly at heart more than operating efficiencies.

Instead, today's mergers and affiliations are more a reflection of several factors that are making independent hospitals, and, in fact, comprehensive service hospitals of all kinds, functionally obsolete.

The new dynamics of consolidation Today, many systems of significant size are combining—or in some cases, trying and failing to combine.

The dynamism around the acquisition and affiliation game has never been stronger.

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What's more, Cosgrove says, the drivers of consolidation have changed.

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