nurse standing by patient in hospital bed (Photo: Shutterstock)

Five years ago, rival hospital companies in the blue-collar corner of Appalachia – in Johnson City, Tenn. – made a deal. If state lawmakers let them merge, leaving no competitors, the hospitals promised not to gouge prices or cut corners. They agreed to dozens of quality-of-care conditions, spelled out with benchmarks, and to provide hundreds of millions of dollars in charity care to patients in need.

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