Institutions are assessing the impact of the Affordable Care Act, ACA, and other healthcare reforms on their business strategies and models. The key question: are management teams prepared to maintain and improve their competitive position within the dynamic healthcare environment?

Stuart McLean, an Alvarez & Marsal Managing Director, advises not-for-profit healthcare entities on merger integration. He says small institutions are having trouble surviving independently. "In 2008 the $250 million hospital was too small to survive. Today even a $500 million hospital is too small to survive." He discusses the ramifications of the "too small to survive scenario" in this video.