A perfect storm of factors is accelerating the market for hospital-based medical group mergers and acquisitions. Obamacare is shifting economic power to hospitals. Many physicians, especially those who are not particularly entrepreneurial, are moving to hospital employment or otherwise being “aligned,” resulting in changing referral patters. Private equity money has entered the market. Practices that could never, or barely, have been sold ten years ago, are now, in some cases, valued at high multiples of earnings. Some hospital-based group leaders see the potential for a sale as a panacea. They fear that reimbursement may fall, and their hospital-contracts might be lost. So shift, they think, some of that risk to someone else and pocket some profit to boot. Others see opportunity in this market through an entirely different lens. They see tremendous advantage in remaining independent or in structuring their own ventures. Finally, another subset is confused and worried about the future and lacks the structure to take any action at all. But no matter where you fall on that continuum, this book is aimed at providing both medical group leaders and the physician owners of those groups with a basic understanding of hospital-based group acquisitions and, importantly, the alternatives.