Mergers and Acquisitions in U.S. Hospitals May Not Improve Care Quality or Reduce Costs

A recent study published in the Journal of the American College of Surgeons (JACS) has found that mergers and acquisitions in U.S. hospitals do not necessarily improve care quality or reduce healthcare costs.

The systematic review, which included data from hundreds of published studies, analyzed the effects of health care integration on patient outcomes, prices, and spending. The researchers concluded that only about 22% of the studies showed a positive net impact of integration, while nearly half showed a negative effect.

According to lead study author Bhagwan Satiani, MD, MBA, FACS, the findings suggest that evidence is lacking to support the claim that integration alone can improve healthcare value. "Quality improvement in healthcare cannot be achieved by mergers and acquisitions alone," Satiani said.

The review also found that hospital charges increased with integration 93% of the time and health care spending rose in 81% of 16 studies assessing this aspect. In contrast, only one study found a decrease in patient deaths after integration.

Satiani emphasized that while healthcare leaders may need to redefine value with a focus on benefiting patients while maintaining financial stability, quality improvement cannot be achieved through mergers alone. "Standardizing quality metrics and delineating resource to quality efforts is crucial for improving care," he said.

The researchers highlighted that many studies were limited by the use of non-standard measures of quality, price, and spending, as well as a lack of exploration into reasons for poor healthcare value after integration.

This study complements previous research on health care integration but offers several key differences. Many published studies do not reach surgeons, who are directly impacted by the financial performance of hospitals. Furthermore, systematic reviews like this have become increasingly important to reduce bias in healthcare policy and economics publications.

What does this mean for the future of healthcare?

The findings have significant implications for the healthcare industry, particularly for policymakers and hospital administrators. With nearly 70% of U.S. hospitals now affiliated with health systems, it's essential to reevaluate the value of integration. As Satiani said, "Healthcare leaders should focus on improving quality improvement efforts through standardized metrics and resource allocation."

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