This report was made possible with generous funding support from the following foundations and donors: Alki Fund of the Rockefeller Family Fund, the Ford Foundation, the Robert Sterling Clark Foundation and Katharine S. Villers.

The authors wish to thank former MergerWatch Advocacy Coordinator Sheila Reynertson for recognizing the need for this research and getting the project started. Special thanks go the following people for their suggestions on improving the report: Jessica Curtis, Michele Craig.

The authors also wish to thank Ali Harris for his assistance with the state grading system as well as former MergerWatch interns Chelsea Ebin, Sarina Singh, and Ciara Johnson for their research and editing support. 

An abbreviated version of this report appeared in the March 2016 issue ofthe American Medical Association Journal of Ethics, available here.