Hospitals across the country are merging – both with other hospitals and with other health care entities such as clinics and rehab facilities. (Those are sometimes called, respectively, horizontal and vertical integration.)
The question is whether the consolidation is creating more efficiency in the health care system, as hospitals generally argue, or whether it’s creating big monopolistic health care entities that will have more clout in negotiating with insurers and thus will lead to higher, not lower, prices.
Antitrust/ mergers and acquisitions is a topic health reporters often shy away from. But it’s important and we need to pay more attention. To help you, we just posted a tip sheet, “Getting the facts on hospital mergers and acquisitions,” based on an email-interview with Barak Richman of Duke Law School, one of the foremost experts on health care antitrust law. In addition, here are a few additional resources on the topic and some recent coverage about the issue nationally and locally.
The American Hospital Association has a website on hospital consolidation (which AHA, in general, sees as beneficial).
Ashish Jha and Thomas Tsai examine the “is bigger necessarily better” question in a July JAMA essay.
In this Wall Street Journal op-ed, Kenneth Davis, M.D., president of Mt. Sinai Health System in New York, argues that mergers smooth the path toward “population health” rather than the fragmented fee for service.
There has been a spurt of coverage on the topic.
Bruce Japsen, in Forbes, writes about how and why the insurance industry is fighting the wave of mergers, seeing higher costs ahead. (Japsen also writes here for the Chicago Sun Times about a big merger underway in Chicago, which “which would create the 11th largest tax-exempt hospital operator in the U.S., treating 3 million patients annually .”
Politico’s Brett Norman did a Q&A with Martin Gaynor who, at the time, was the top FTC economist dealing with this topic. (scroll to page 18 of this PDF)
The New York Times’ Robert Pear writes about the FTC’s “lonely voice” and success in blocking a few deals – and he argues those few sent a message to other hospitals about the acceptable limits of mergers.
There have been some good stories about specific mergers or specific regions. Molly Rosbach of the Yakima (Wash.) Herald wrote a lengthy story about how mergers and partnerships were affecting her community. And here’s a Wall Street Journal piece by Josh Dawsey looking at what’s going on in the N.Y.-N.J. area.
One related issue: Mergers joining Catholic and non-Catholic hospitals can raise a host of issues, including some about reproductive health. Here’s an earlier AHCJ look at that.
Related
This extensive “Reporter’s guide to health care antitrust issues,” by health journalist Mark Taylor explains the issues and significant cases around antitrust law as well as a list of sources with contact information.
