As hospital systems and insurers continue to buy up medical practices and grow ever larger, the consequences for patients and the health care system writ large are serious. In Congress, the House Budget Committee is looking at how these mergers affect cost, access to care, and health outcomes. Republicans and Democrats agree that consolidation in the health care space must stop before health care costs escalate even more, reports Rebecca Pifer for HealthCareDive.
To bring down Medicare spending, Republicans and Democrats appear to support ensuring that Medicare payments are the same for the same services, whether they are performed at a physician’s office or a hospital-owned outpatient facility. This fix would seem like low-hanging fruit for Congress, but Congress has failed to address this small issue for a very long time.
Health care prices keep going up overall. Republican Congressman Ron Estes, captured the sense of the members: “We just can’t afford to have this continued increase in prices.” Substantial evidence indicates that consolidation in the healthcare marketplace is driving up costs.
Equally substantial evidence shows that consolidation is not improving quality of care. In 2022, Rand studied the data and found hospital consolidations lead to price increases of as much as 65% percent.
To be clear, consolidation in the health care market is not happening because physicians are asking for it. In fact, most physicians don’t want it. Physicians usually have no choice but to sell their practices to private equity firms and insurers if they want to continue to treat patients.
The hospitals and health systems buying physician practices want more power to secure higher prices from insurance companies and Medicare. For their part, physicians need help handling all the bureaucratic obstacles insurers impose on them. Not surprisingly, between 2005 and 2022, 15 percent more community hospitals had joined a health system, up from 53 percent to 68 percent. In the 10 years between 2012 and 2022, 12 percent more physicians moved from independent practices to working at a hospital, from 29 percent to 41 percent.
Here’s more from Just Care:
- Non-profit hospital systems compromise patient safety
- Want surgery? Some hospitals make you pay upfront
- Half of rural hospitals are losing money, closing units
- For-profit hospitals urge CMS to hold Medicare Advantage plans to account for wrongful denials
- If you’re in a Medicare Advantage plan, watch out! Your doctor or hospital might no longer be in-network
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