Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and to better compete in their markets. The challenge many face is that providers are not benefiting at insurers' expense and physicians' incomes are barely growing, hospitals (especially flagship teaching hospitals) are on the financial ropes, and growing drug benefits are still less than 10 percent of the total compensation. How can hospitals and physicians resolve this problem in the wake of the economic recession of 2007 to 2009