For over two decades, healthcare has been under siege to manage care and provide services that offer quality, effectiveness, and cost efficiency. In the early 1990s, managed care swept the nation resulting in hospitals joining together in integrated health systems. In 2015, merger mania proliferated; hospitals are consolidating, creating large hospital systems with broader service reach and economies of scale to compete in the value-based environment. The value proposition is focused on successfully transitioning from hospital centric care to primary and community-based care. While much has been written about clinical integration transactions, less is known about how academic health systems are moving from acute care models to community-based models through linking education and practice. In addition, as consolidation continues, there is a new imperative to engage communities that surround the hospitals for true community benefit. This includes increasing accountability of hospitals, building community capacity, and engaging communities in primary care, improving health and addressing health issues.
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