"Merger mania" is sweeping the nation as hospitals, insurance companies and other healthcare institutions consolidate to help satisfy the mandates of the Affordable Care Act. While the conventional wisdom says that consolidation hurts care access and competition, one physician believes that when hospitals merge, patients actually benefit.
Hospital mergers will help patients by consolidating medical records electronically and coordinating care between institutions, which will eliminate redundant costs and treatments, writes John D. Birkmeyer, M.D., executive vice president of integrated delivery systems at Dartmouth-Hitchcock Health and a professor of surgery at Dartmouth's Geisel School of Medicine, in a piece for Harvard Business Review.
Furthermore, Brinkmeyer says merging facilities can help eliminate "the persistent problem of variation in healthcare practice and outcomes, particularly in surgery." Recent research, he says, shows that thousands of Americans whose surgeries are performed by low-volume surgeons and hospitals die unnecessarily every year.
The answer, he argues, is for hospitals to adopt a "volume pledge," listing 10 complex procedures "for which scientific evidence shows that surgical volume matters" as off-limits for surgeons who perform fewer than a certain number of such patients per year. Consolidating hospitals, Brinkmeyer says, makes it far easier to adopt and enforce these guidelines.
Standardization of care across hospital groups will also help raise the standard of care rather than reduce it, he says. But others are not convinced and say the mergers will actually reduce standard of care while jacking up costs.
"Unfortunately, the evidence belies all the claims and promises. Northwestern University researchers found that prices increase on average 14 percent after a hospital's acquisition," says Jean Bestafka, R.N., former CEO of the New Jersey Home Health Services Association, in an opinion piece published by the Newark Star Ledger.
Leading healthcare associations also question the wisdom of mega consolidations.
The American Medical Association released a study in September that found that the potential mergers between Anthem-Cigna and Aetna-Humana would "diminish competition" in 58 metropolitan areas within 14 states.
"A lack of competition in health insurer markets is not in the best interests of patients or physicians," AMA President Steven J. Stack, M.D., said in an announcement about the findings. "If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care"