Some are acquiring other hospitals; others, expanding vertically, are adding clinics, and others are considering forming their own insurance mechanism.
As Columbia has tried to acquire hospitals across the country, it has often found itself at loggerheads with some state regulators, not-for-profit hospitals and community groups.
One of the country's largest groups, Catholic Healthcare West, based in San Francisco, has been rapidly acquiring hospitals.
Hospital chains like Columbia and the Tenet Healthcare Corporation would have new opportunities to grow by acquiring weak nonprofit hospitals pushed under by the cutbacks.
For Columbia, the Value Health deal suggests an alternative avenue for growth as it is becoming more difficult for it to acquire hospitals.
In addition to acquiring hospitals, Columbia has added a residential mental health center for adolescents and children.
(In New York, state law effectively bars publicly traded corporations from acquiring hospitals.)
Around the start of the 20th century a cooperative acquired the buildings and converted them in 1901 to the at the time most modern hospitals of Styria.
Gone is the seemingly insatiable appetite for acquiring competing hospitals that has made Columbia one of the most feared participants in the health care industry.
Gone also is the seemingly insatiable appetite for acquiring competing hospitals.