Twin cities health care mergers, acquisitions, and affiliations. Implications for independent physician practices.

"The health care system in Minnesota, especially in the Twin Cities area, is currently undergoing change that can best be characterized as a consolidation of providers into larger and larger groups (multispecialty clinics, hospital/physician mergers, and expanded HMOs and PPOs). These changes are intended to produce economies of scale, less duplication of services, and better control of costs and quality of health care. Where does this leave the more traditional, smaller multispecialty or single-specialty practices often referred to as 'independents'?... How can independent groups respond to these trends in order to survive in the new health care marketplace?"