The healthcare industry landscape, historically subject to constant change, is now increasingly becoming an unpredictable environment of new provider structures, strategies and tactics. New forms of alignment and integration have arisen within an accelerating pace of transactions involving the acquisition of physician practices (or specific assets of those practices) and the subsequent employment of the selling physicians by the acquiring hospitals. The perceived volatility of this pattern of change is driven, in part, by the growing concern over rising healthcare costs; the current economic environment of slowed growth; high unemployment; and, record federal deficits and debt, resulting in a perfect storm and catalyst for change. In developing an understanding of the forces and stakeholders that have the potential to drive healthcare markets, it is useful to examine what value may be attributable to healthcare enterprises, assets and services as they relate to the Four Pillars of the healthcare industry, i.e., regulatory, reimbursement, technology, and competition . Health Capital Topics is a monthly newsletter which has been published by Health Capital Consultants since 2007, featuring timely topics related to the regulatory, reimbursement, competition, and technology aspects of the U.S. healthcare delivery environment. It is sent to over 12,000 healthcare executives, physicians, attorneys, accountants, and other professionals in the healthcare industry. Copies of past monthly issues and special alert issues can be found at www.healthcapital.com. This book is a compilation of excerpts originally published in the newsletter, HC Topics, which have been organized by topic in relation to the Four Pillars concept. The intent of this book is that it will serve as an (admittedly abridged) brief primer and reference source for these issues.