[WindyCityzen]

Nonprofit only means they do not have shareholders ... that profits (if any) are retained not distributed. Nonprofits may or may not pay federal business income tax on their mission-related businesses. (They undoubtedly pay many other taxes on unrelated activities, e.g, renting out office space to doctors.). The profit and tax exempt statuses are technically unrelated. Bottom line: All of this has little if any effect on how they negotiate with insurance carriers. Also, just saying ... if the US had a single payer system like all other first-world nations, none of of this would even occur.