The effect of hospital ownership conversions on nonacute care providers

Using interorganizational theory and qualitatively exploring five specific hospital conversions, this article examines how a change in ownership status affects a hospital's competitive and collaborative behavior toward nonacute care providers serving vulnerable populations. Community benefits were found to be a sound foundation for analyzing the impact of hospital conversions on local communities, but the concept needs to be expanded to take into account not only the scope and intensity of hospital services provided but also the impact on community-based providers. In this framework, conversions were found to affect communities differently and produce varied effects for the stakeholders. Communities also were found to be active participants in determining how conversions would affect them and the local delivery system in which they would operate.