Over the past 20 years, the percentage of the nation’s hospitals over 200 beds that are part of health systems has risen from 5 to 77. From 2006 to 2016 alone, the number of independent hospitals over 200 beds declined nearly 40 percent from 502 to 308. The seemingly inexorable trend toward system expansion has caused industry observers to state frequently that stand-alone community hospitals are “dinosaurs.” However, there are circumstances under which stand-alone hospitals can continue to thrive. There are also a multitude of new partnership arrangements that make it possible for successful institutions to retain a high degree of independence while securing many of the benefits of hospitals that are affiliated with larger health systems.
In our experience, successful independent hospitals share many of the same advantages, a subset of which are described in this paper.