As healthcare grows more interconnected, standalone community or government-owned hospitals are facing a crisis. Many need partnerships or clinical affiliations with allied healthcare providers and tertiary hospitals that can provide care, and in some cases capital, that they cannot. They may make an unattractive merger partner for larger hospitals and health systems that may also have capital constraints. Even if the local hospital is an attractive merger partner, many boards do not want to give up the local control over available services and the jobs the local hospital provides to local residents. There are other ways to reach the goals of better, more coordinated, and value-added care, and in many cases, preserve the hospital long-term.