Is All Health Care Local?

When I started in the field, there was an adage that drove strategy—all health care is local. Hospitals were the hub of local health care, serving as the focal point for an informal network of local outpatient services. Health care wasn't “brandable” like Century 21 real estate offices, or “franchiseable” like McDonald's restaurants, or managed by “national chains” like Marriott Hotels. What a difference a couple decades make. We're seeing all of this in the health and human service space—branding, franchise-like models, and national chains are increasingly common.

These market developments have tended to . . .