Provider trade associations have long claimed that hospital mergers boost the quality of patient care. But recent research funded by the U.S. Department of Health and Human Services calls this assertion into question.
According to a recent paper published in New England Journal of Medicine, following hospital mergers and acquisitions, patients had poorer experiences, and there was no significant change to readmission and mortality rates. The authors say the change to patient care was comparable to falling from the 50th to the 41st percentile.
Hospital mergers — more expensive and worse care?
“These findings challenge arguments that hospital consolidation, which is known to increase prices, also improves quality,” the authors explained in the NEJM article.
Researchers came to this conclusion after looking at Medicare claims and Hospital Compare data from 2007 through 2016 for 246 acquired hospitals and 1,986 control hospitals (which did not experience a merger). They analyzed the information using four metrics: clinical-process measures, patient-experience measures, 30-day mortality and 30-day readmission rate.
The research team was unable to form any conclusions regarding clinical-process measures, which included scenarios such as the percentage of patients given the appropriate medications at discharge.
Interestingly, the researchers observed a decrease in patient experience regardless of size of the hospital post-merger and the types of patients admitted. That said, the study has limitations. Researchers didn’t look at affects of particular acquisitions, and they could not rule out that control hospitals might be affected by nearby mergers.
How do mergers affect clinicians?
While this study did not explore how providers view mergers, a recent survey from medical staffing resource LocumTenens.com did. It found that 41 percent of its respondents, comprising both physicians and APPs, worked at an organization that had a merger or acquisition.
Of these, some 41 percent said “consolidation brought their organization increased access to additional resources, technology and expertise,” according to the LocumTenens.com report. Another 48 percent of respondents involved in mergers said they did not feel valued by the organization post-consolidation.
Some 43 percent of respondents also said they believe the cost of care for patients did not decrease, and 35 percent said the quality of care did not increase. This is compared to 14 percent and 23 percent respectively who said the opposite. Similarly, 36 percent said their organization has not become more efficient post-merger, while only 20 percent said it had.
“There is a loss of culture and a lack of genuine care of employees,” noted one ophthalmologist from the southeast. Meanwhile, one NP neurologist from the Northeast saw the merger as positive: “It helps patients as we will now have specialties we didn’t previously have, so patients don’t have to travel so far.”
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