Cooperation. An alternative to consolidation or bankruptcy

With all the recent consolidation and doomsaying within the EMS industry, the music from the movie "Jaws" is likely playing a constant refrain in the minds of many smaller EMS providers. The word from the consolidators--those large companies buying up small and midsized ambulance services--is that health maintenance organizations (HMOs) soon will be purchasing EMS and other "out-of-hospital" services and that since HMOs are for-profit institutions, they will be looking for the least expensive EMS delivery system. The consolidators and others with a stake in the new order assert that cost-effective services can only be produced by large national EMS companies; smaller companies will be left out in the cold. But will they?