The risk management issues in today's hospitals are the following:

1. Technology: Technology and connectivity will continue its steady infiltration of the healthcare landscape, branding and trust take priority over convenience, and the advancement and integration of connected health technologies will center on cybersecurity.

2. Hospital Mergers: Independent hospitals may find it difficult to compete as bigger competitors merge, and brand recognition will become crucial to attracting consumers.

3. Drug Prices: The increasing prices for viable drugs people need to live.

4. High Deductible Plans: Between the movement of employer-sponsored plans to high deductible plans and the growth of healthcare exchanges, consumers have more and more responsibility for their healthcare costs.

5. Layoff: Due to hospital revenue reductions because of minute clinics and outpatient care facilities.

6. Physician Competition: Bigger and private hospitals offering better technology and salary packages for the brightest and popular physicians.

You have identified some key risk management issues which must be managed in today's healthcare environment. What have the trends been in the U.S. regarding healthcare system mergers?