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With healthcare, is bigger always better?

The Washington Post, August 16, 2010

Carilion Clinic owns the two hospitals in Roanoke, VA, and six others in the region, employs 550 doctors and has set off a bitter local debate: Is its dominance a new model for health care or a blatant attempt to corner the market? Carilion says it represents an ideal envisioned by the nation's new healthcare law: a network that increases efficiency by bringing more doctors and hospitals onto one team, integrating care from the doctor's office to the operating room. The name for such networks, which the new law strongly promotes with pilot programs, is accountable care organizations, or ACOs -- providers joining together to be "accountable" for the total care of patients, with incentives from insurers to keep people healthy and costs down.