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The trend toward vertical integration in the healthcare industry and more employment of physicians by hospitals and health systems does not improve quality on key metrics, according to a recent study.
The study from the Center for Health and Biosciences at Rice University’s Baker Institute for Public Policy also found lower patient satisfaction scores for hospitals in concentrated markets. (The study is available at: https://bit.ly/2E9FHeK.)
Researchers studied the performance of 4,438 hospitals on 29 quality measures reported on Hospital Compare from 2008 to 2015.
Hospitals with employed physicians had higher scores on only eight of the measures. Readmission rates were the same for physician-employed hospitals and other hospitals.
More physicians than ever before are employed by hospitals. The study notes that approximately 155,000 physicians were employed by hospitals in 2016, a 63% increase from 95,000 in 2012.
The researchers concluded that their “findings do not uphold the hypothesis that increased integration may result in better care, likely because structural integration (e.g., human resource management, financial management, etc.) through physician employment does not necessarily lead to clinical integration (e.g., coordinated patient services among providers or site, monitoring of ‘best practices,’ etc.).”
“Our results indicate that vertical integration improves quality for only a limited set of process of care and patient satisfaction measures,” they wrote.
“But increased hospital market concentration is strongly associated with reduced quality across multiple measures,” the researchers wrote.
“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.”
Financial Disclosure: Author Greg Freeman, Editor Jesse Saffron, Editor Jill Drachenberg, Nurse Planner Jill Winkler, Editorial Group Manager Terrey L. Hatcher, and Consulting Editor Patrice Spath report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.