The current pace at which U.S. cardiology physician practices are merging with hospitals and integrated delivery networks (IDNs) has only quickened since the massive CMS cuts, which took effect at the beginning of 2010. According to a recent American College of Cardiology (ACC) survey, 54 percent of practices reported integration is being actively pursued or on the horizon. Executives and cardiologists from Minneapolis Heart Institute (MHI) and Piedmont Heart Institute (PHI)two geographically different practices, with varied models of integration, governance, physician compensation and vendor contractscame together to discuss these issues, along with an attorney, who has brokered many integrations on behalf of physicians.