Kahn counters that the arguments about consolidation driving cost growth loses some steam with the news that healthcare cost growth has slowed to record lows. "It's probably the economy, but consistently economists and government officials and other studies are showing that a structural change is taking place," he says.
"Hospital services are paid for through this tremendous hydraulic that is Medicaid and Medicare payments, no payment, and then various types of private payment," he says.
"As far as we are concerned and as far as our study illustrates, to keep this hydraulic greased so that there are enough resources to provide the access that people expect and the quality that people expect, the freestanding hospital can't make it. You need to look at the big picture of hospital survival and the availability of hospitals. That is the point we are trying to make," Kahn said.