CHICAGO — Fundamental changes in the way non-profit hospitals do business — chief among them the way they are paid — are driving the consolidation trend that has marked the sector over the past year, Fitch Ratings says in a new special report.

One of the biggest changes tied to the new federal health care law, which takes effect in 2014, is a shift from a volume-based fee-for-service payment model to a performance or value-based model that is tied to outcome, Fitch says in the report, "Nonprofit Hospital Consolidation, Integration and Alignment."

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