, 2009). Often, the problems come about because the hospitals see their costs rising and yet they are not getting the payments they are owed (D'Antonio, 2010)
Even for a large, multi-million dollar company with plenty of assets, that is too much to be losing on a consistent basis if there are any plans to stay afloat or to build the company and allow it to grow into something more significant and more valuable to the patient base and the community. The cost of separation after a merger is generally very high, no matter what the company or industry (Smith, 2002; Tulenko, et al