Reconstitution of the not-for-profit hospital: new ethics, new equity

In meeting the challenge of economic competition, the not-for-profit hospital has made two significant responses: corporate reorganization and formation of multihospital systems. However, an additional response is needed to improve access to equity capital. This can be achieved by separating the hospital into a not-for-profit entity that contains nursing care, administration, and support services and a series of economic partnerships with members of its medical staff and other investors for provision of ancillary diagnostic and treatment services. Additionally, it is proposed that the parent holding company add an insurance arm, form a primary care network, and vertically integrate all modalities of care.