The hospital groups have also tried to hold down nurses' salaries.
State medical and hospital groups plan to press for legislation in at least 20 more states this year.
After the first report, health officials and hospital groups pledged reforms, but many of the most important efforts have been slow to take hold.
George B. Allen, a retired executive at a hospital group.
The hospital group and the union spent an additional $1 million on their own, for a total of $3.85 million last year.
It is true that almost all of the private hospital groups have multiple links with each other.
Two large hospital groups taken private in the 1980's are preparing to return to the stock market.
It is a leading private hospital group in Germany.
He said that more than a dozen other businesses, including retailers and hospital groups, had expressed interest in leasing space.
The hospital group estimated the cost to New York hospitals at more than $100 million a year.