While Clark County commissioners spent the past decade studying, debating and then studying some more about what to do with University Medical Center, public hospitals around the country have been adapting to the evolving health care landscape. One of the major changes undertaken in cities such as Atlanta, Minneapolis and Denver was to get government out of the hospital and give oversight responsibilities to an independent board of experts. The changes have been accomplished in different ways in different cities — in some, hospitals were spun off into nonprofit corporations, in others they were made into stand-alone government subsidiaries — but the results have generally been positive, leading to increases in philanthropic giving, better care and a more stable financial outlook.