Ball Memorial Hospital officials spent much of the mid-2000s looking over their shoulders. Indianapolis-based hospitals grew dramatically in the first decade of the 21st century, building new facilities and advertising to attract patients from throughout Central Indiana. By 2007, one of the state's largest healthcare providers, Clarian Health, was even considering building a hospital facility on Muncie's west side. The plans never came to fruition, but threat of competition combined with millions of dollars in losses -- much of it due to what the hospital called unfair federal Medicare reimbursement -- had Ball Memorial reeling. By 2008, the merger of Ball Memorial into Clarian was announced. It became official in 2009. By 2010, Clarian announced it would change its name to Indiana University Health even while economies of scale meant IU Health Ball Memorial's finances were slowly improving. The upturn in finances was tied very directly to improvements in the relationship with local doctors, both physicians and hospital officials say.