One of the most dramatic changes right now is that large hospital companies are getting bigger. In one of a series of corporate mergers and acquisitions that have taken place recently, Tenet Health care (Tenet Health care) issued a statement on June 24 that it would acquire Vanguard Healt hSystems for $4.3 billion and assume its debt. The combined group will have 79 hospitals and 157 outpatient clinics.