Question special

One criticism I have heard is that solo physicians and small groups do not have the economies of scale needed to participate in alternative payment models that require large amounts of data collection and administrative reporting. Other than providing financial incentives for providers in help them take a risk in investment, are there any proposals for how to make participation a possibility for all providers? Is there any concern that these new payment models contribute to hospital mergers and practice acquisitions which could in theory drive up costs by decreasing competition?