Integrated systems of care can provide immense value to patients and communities. At a time when hospitals around the country face mounting financial pressures, integrating systems of care helps prevent closures, increase quality of care, keep hospitals open and enhance patient access to care.
In a recent study backed by Arnold Ventures, the authors erroneously argue that integration raises healthcare costs at the expense of patients. However, the study’s design has major blind spots and methodological failures. It fails to account for the numerous and significant ways that integrated care benefits patients and communities.
The study also ignores the fact that many corporate insurance companies have played a significant role in destabilizing independent providers in the first place through excessive administrative requirements and unsustainable payment rates and have then rushed to buy up physician practices and consolidate their grip on all aspects of patients’ healthcare. In fact, one single corporate insurer now employs or oversees 10 percent of all physicians in the U.S. In many deals that include hospitals and physicians, the physician practice approached the hospital as an alternative to payer acquisition. Further, the study relies on limited data and other flaws in design.
Here are the facts:
Integrated systems of care benefit patients and increase access to care:
- Integration helps keep hospitals and other sites of care, like physician offices, open. Acquisitions can save hospitals, including those serving rural and underserved communities which would otherwise close due to financial and administrative pressures.
- During the COVID-19 pandemic, rural hospitals affiliated with systems were more likely to have stable finances, indicating that system affiliation can benefit rural hospitals in a variety of ways, including by supporting rural hospitals facing serious financial challenges.
- Integrated systems of care can allow hospitals to provide higher quality patient care by utilizing shared resources, staff and expertise.
- One study found that almost four in 10 acquired hospitals added at least one new service after integration.
- Hospital integration supports increased access to care and lower healthcare costs.
- Hospital integration can enhance patient care and even lead to better mortality rates for certain conditions. This can help reduce urban-rural disparities in access to care.
Corporate insurance companies and other entities are responsible for more physician acquisitions than hospitals and are the primary entities driving up healthcare costs:
- A recent study showed that the majority of physician acquisitions in the last five years were carried out by corporate insurers and other kinds of entities, not hospitals.
- In fact, UnitedHealth Group and its subsidiary Optum are the largest employer of physicians in the country, with more than 90,000 employed or affiliated physicians.
- When corporate insurers buy up physician practices, it leads to higher costs for patients. While insurers’ profits go up, consumers and employers are unlikely to see savings passed on to them.
- Insurers’ excessive consolidation in American healthcare can have devastating consequences.
- Just look at the recent Change Healthcare cyberattack: Two months after the attack, providers continue to experience significant disruptions and financial instability.
- Meanwhile, UnitedHealth Group may be exploiting the very emergency they failed to stop — using the pain the cyberattack has caused providers, on top of the administrative burden already destabilizing practices, as leverage to buy up even more physician practices while they are vulnerable.
The contrast is clear. Hospitals use integration to preserve and expand patients’ access to care, including by shoring up distressed sites of care. Many corporate insurers use acquisitions to pad their profits and grow their power.
The benefits of hospital integration are significant. Hospitals that become affiliated with a larger system can stay open, keep providing high-quality care to patients in need and further improve the care they offer.
If policymakers want to protect patients, they must hold corporate insurance companies accountable for prioritizing profits over patients and ensure that hospitals and health systems have the resources they need to continue providing access to care.
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