For-profit healthcare systems are buying not-for-profit healthcare systems. Not-for-profit healthcare systems are buying for-profit systems. Everyone is buying physician practices. Some are buying health insurers. Health insurers are eying healthcare systems.

The healthcare industry is consolidating.

And all because of the Affordable Care Act (ACA), which was passed by Congress and signed into law by President Obama in March 2010. Even before the Supreme Court rendered a final decision in June 2012 to uphold the law, every healthcare organization in the United States was looking at how they’d restructure the way healthcare is provided to address provisions in the ACA.

And just like the airline and banking industries, technology is also driving some of this consolidation. Think back to when you used to actually have to go to a bank and interact with a teller to deposit a check, get cash, or see how much was left in your account.

Now most of us do these things online or at an ATM machine. And we book our airline tickets online and download boarding passes to our smart phones.

It cost a lot of money to put those technologies in place—which is one of the reasons why the smaller banks and airlines merged with the big ones.

Hospitals are heading in the same direction. Why? Because creating a continuum of care focused on wellness in which patients take responsibility for their own health will require the same kind of connectivity to access our records, make appointments, monitor vitals, communicate with doctors and nurses, etc. That takes capital that many smaller healthcare systems don’t have or can’t access at an affordable borrowing rate.

What does all this consolidation mean for healthcare facility design and construction?

Probably a lot fewer big hospital projects, but still a need for acute care facilities that promote patient safety and contribute to quality outcomes.

In other words, there will be more renovations and maybe an occasional (smaller) replacement hospital; acquired facilities will need updated to meet the parent system’s standards, technology, and energy conservation requirements; and new ambulatory care clinics will sprout up, perhaps located in a former Best Buy store or the Mall of America.

There are other implications for the practice of architecture and design in the United States, as well as for the business model of healthcare specialists. Be sure to read what the experts have to say about all this in my article in Healthcare Design’s March 2013 issue.