Hospital consolidation troubling, Hopkins doctors say

Johns Hopkins doctors and researchers ask federal government to be more cautious in approving hospital mergers

A group of Johns Hopkins doctors and professors have called on the Federal Trade Commission to act with more caution when considering hospital mergers.

The consolidation of hospitals into large chains makes the market less competive, gives patients fewer choices and could result in higher medical expenses, the researchers said in a commentary published in the Aug. 13 edition of the Journal of the American Medical Association.

The authors of the article want the FTC to pay particular attention to mergers that could result in one dominant hospital system in a region.

There were 193 mergers in 2013 and 2014 and about about one-fifth of U.S. hospitals are expected to seek a merger in the next five years, the authors found.

A 2013 analysis, also published in JAMA, found that none of the 306 geographic health care markets in the United States are considered highly competitive. Nearly half of these markets are dominated by a single system.

The authors are not totally against mergers and said that “limited integration” has benefits. There is evidence that when large medical centers collaborate with smaller community hospitals it can improve patient care, they wrote.

Research by the Robert Wood Johnson Foundation found patients living in competitive health care markets have better health outcomes and lower death rates than people in less competitive markets, the authors found.

They said too many mergers could lead to a situation similar to that in 2008 when the federal government had to bail out big banks. The failure of a large hospital system could lead the government to intervene, the authors argue.




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