Ten Things to Know About Consolidation in Health Care Provider Markets

Mergers and acquisitions involving hospitals and different well being care suppliers are drawing consideration from federal and state regulators, together with the Federal Commerce Fee, and policymakers amid considerations that such consolidations can scale back competitors and contribute to the excessive prices of well being care.

A brand new KFF transient examines and summarizes the proof about consolidation amongst well being care suppliers as extra neighborhood hospitals turn into half of a bigger system, and extra physicians are in practices owned by hospitals and techniques.

Drawing from all kinds of sources, the transient presents insights into the tempo of consolidation amongst suppliers, its affect on costs and high quality, and coverage proposals aimed toward lowering consolidation and rising competitors, reminiscent of:

Following a wave of consolidation within the early- and mid-Nineteen Nineties, there have been 1,573 hospital mergers from 1998 to 2017 and one other 428 hospital and well being system mergers introduced from 2018 to 2023.

The share of physicians working for a hospital or in a apply owned at the least partially by a hospital or well being system elevated from 29% in 2012 to 41% in 2022. As well as, a rising share of doctor practices are owned by different company entities, together with insurance coverage corporations.

Whereas consolidation could permit suppliers to function extra effectively, a considerable physique of analysis reveals that it usually results in greater well being care costs. The proof total doesn’t present clear good points in entry or high quality. 

Some research have discovered that hospital consolidation can result in decrease wages for some expert staff, reminiscent of nurses. The broader proof on employment and compensation results is proscribed, together with the extent to which mergers that forestall closures may protect jobs.

State and federal coverage proposals to deal with consolidation and enhance competitors embrace strengthening antitrust enforcement, lowering monetary incentives for supplier consolidation, rising worth transparency, and permitting extra suppliers to enter the market. Every of those proposals would contain tradeoffs, and the extent to which they’ll scale back well being prices is unclear since many markets already are extremely concentrated.

The transient is a part of KFF’s increasing work analyzing the enterprise practices of hospitals and different suppliers, and their affect on prices and affordability.