Hospitals that employ physicians don't necessarily provide better care, according to a new study.
New research published in Medical Care Research and Review also reveals that patients who live in highly concentrated hospital markets are less satisfied with the care they receive.
The study analyzed 29 quality measures previously reported to the Centers for Medicare & Medicaid Services’ Hospital Compare database. Looking at discrepancies between the years 2008 and 2015, the goal was to determine whether vertical integration between hospitals and physicians and increases in hospital market concentration influenced overall patient outcomes.
The researchers found that combining physician practices with hospitals has had little impact on the quality of care at hospitals, but increased market concentration does reflect reduced quality across 10 patient satisfaction measures.
The number of hospital-employed physicians increased by more than 63% between 2012 and 2016, and by mid-2016, 42% of physicians were employed by hospitals. And while many hospitals and policymakers had hoped that increased integration would improve care coordination, the study calls that into question.
“With fewer competitors it seems that there is less incentive to keep patients content,” stated the report. “Given the nature of some satisfaction measures, such as explaining medications and communicating well with patients, overall clinical quality could suffer if patients do not properly understand care recommendations during their hospital stay or post-discharge.”
Although a better patient experience may not always correlate with higher clinical quality, measuring quality based on patient perception is increasingly important as more consumers use online physician ratings and reviews of patient experiences to select providers. Online reviews are even more important with young people, who are picking their providers and physicians based on ratings from their peers.
The authors of the study concluded: “With this result in mind, regulators should continue to focus scrutiny on proposed hospital mergers, take steps to maintain competition and reduce counterproductive barriers to entry.”