The Deloitte study also points out the increasing interest in acquisitions of hospitals not only by for-profit chains, but also by venture capital funds and other nontraditional acquirers, whose allegiance to shareholders outweighs any other influence.
Value creation, therefore, is now a central reason for mergers to take place. In healthcare it hasn't always been so high on the list of measured "outcomes" from a merger, if you will. Deloitte notes a significant difference in financial performance when the acquisition is by a national chain rather than a local or regional one.
Sure, increased merger success of late has something to do with the increased rigor, scale, and, yes, on accountability being forced on what has been largely a nonprofit industry for the past 100 years or so.
Whether they're designated for tax purposes as nonprofits or not, profits matter for every hospital—a lot—and hospitals are getting a lot better at extracting it. Especially those, it seems, who serve shareholders first. Whether that's good or bad for healthcare is another discussion.