Accountable care organizations are growing slowly in some parts of the U.S., pushing physicians who cannot find one in their area to merge with other practices to create single- or multi-specialty groups and increase their negotiating power, said health care attorney John Fanburg of Brach Eichler. Small practices will face more challenges because they operate on lower margins and reimbursements are likely to decrease, says Halley Consulting Group CEO Marc Halley.

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