What effect does consolidation in U.S. health care markets have on health care spending, care intensity, and quality mea
Jan 2013 - Current (13 years 7 months)
Performing a systematic review of 5,020 studies to find how consolidation and mergers within the healthcare system affect costs, prices, utility and outcomes. Over the past two decades, the rate of U.S. hospital mergers and integrated health systems has increased, leaving local health care markets increasingly consolidated. Using data compiled by the American Hospital Association, in 1991, 71 percent of American metropolitan service areas (MSA) with more than 100,000 residents were considered “highly concentrated;” by 2003, 88 percent of U.S. MSAs were highly concentrated. While this trend was originally attributed to hospital systems’ response to the bargaining power of health maintenance organizations (HMOs) and other consolidated insuran