This article describes the results made by Ramsey Clinic during the second year following consolidation of the Clinic with a Hospital (St. Paul-Ramsey Medical Center); a medical education/research Foundation (Ramsey Foundation) into a public benefit corporation (Ramsey HealthCare, Inc.). Many issues inspired Ramsey Clinic to examine ways and means to stabilize its growth and development as a multi-specialty physician and dentist group practice in the highly competitive health care environment of Minneapolis-St. Paul, MN. Influencing the need to change were such elements as shrinking reimbursement for physicians from government and other third party payers; increasing malpractice and general liability premiums; as well as, escalating competition among area health care providers reflected by significant variations in charges for similar services and exclusivity agreements with HMO's and PPO's for select services. In the fall of 1987, Ramsey Clinic consummated its consolidation as a subsidiary member of Ramsey HealthCare, Inc., a public benefit corporation established by an Act of the Legislature of the State of Minnesota, 1986 Laws of Minnesota, Chapter 462. As a public benefit corporation, Ramsey HealthCare, Inc. was chartered to "engage in the provision and delivery of health care and related services." Ramsey Clinic serves as the physician organization for the corporation. An article appeared in the March/April 1989 issue of the Group Practice Journal titled "A Natural Partnership" which described the Ramsey approach and illustrated 1988 results following consolidation. Continued change has resulted in further integration of services among the subsidiaries with a focus on expense reduction, revenue enhancement and increased operating efficiencies. This article provides a longitudinal follow-up on operational amalgamations and 1989 results.