In today's market, virtually any discussion of the future plans of a health care organization will include references to affiliation, integration, merger, acquisition or network formation.

Providers are increasingly convinced they need to integrate to survive, and that conviction is overriding traditional biases in favor of independence and autonomy.

Several forces are encouraging this wave of provider integration, including market demands for increased efficiency and lower costs, need for access to capital, and changes in the reimbursement system.