The idea was by creating a national network, you would get operating efficiencies and greater negotiating power with the HMOs. Somehow the operating efficiencies didn't bear out. Maybe these centers weren't as inefficient as people thought to begin with. It also turned out that negotiating power on a national level wasn't that important in an industry where things are still played out on a regional level. Products like these have rapid market adoption.
Payers tend to push back less on products that save lives.
We also want to invest in technologies where industry consolidators exist. We are looking at medical devices on the theory that as long as people are dying, there will be a need for new technology. Devices don't have as long a development time as drugs. I like devices because they present an engineering challenge, not a medical challenge. They have inherently less technical or scientific risk than drugs.