TY - JOUR
T1 - Financial integration’s impact on care delivery and payment reforms
T2 - A survey of hospitals and physician practices
AU - Fisher, Elliott S.
AU - Shortell, Stephen M.
AU - O’malley, A. James
AU - Fraze, Taressa K.
AU - Wood, Andrew
AU - Palm, Marisha
AU - Colla, Carrie H.
AU - Rosenthal, Meredith B.
AU - Rodriguez, Hector P.
AU - Lewis, Valerie A.
AU - Woloshin, Steven
AU - Shah, Nilay
AU - Meara, Ellen
N1 - Publisher Copyright:
© 2020 Project HOPE— The People-to-People Health Foundation, Inc.
PY - 2020/8
Y1 - 2020/8
N2 - Health systems continue to grow in size. Financial integration—the ownership of hospitals or physician practices—often has anticompetitive effects that contribute to the higher prices for health care seen in the US. To determine whether the potential harms of financial integration are counterbalanced by improvements in quality, we surveyed nationally representative samples of hospitals (n = 739) and physician practices (n = 2,189), stratified according to whether they were independent or were owned by complex systems, simple systems, or medical groups. The surveys included nine scales measuring the level of adoption of diverse, quality-focused care delivery and payment reforms. Scores varied widely across hospitals and practices, but little of this variation was explained by ownership status. Quality scores favored financially integrated systems for four of nine hospital measures and one of nine practice measures, but in no case favored complex systems. Greater financial integration was generally not associated with better quality.
AB - Health systems continue to grow in size. Financial integration—the ownership of hospitals or physician practices—often has anticompetitive effects that contribute to the higher prices for health care seen in the US. To determine whether the potential harms of financial integration are counterbalanced by improvements in quality, we surveyed nationally representative samples of hospitals (n = 739) and physician practices (n = 2,189), stratified according to whether they were independent or were owned by complex systems, simple systems, or medical groups. The surveys included nine scales measuring the level of adoption of diverse, quality-focused care delivery and payment reforms. Scores varied widely across hospitals and practices, but little of this variation was explained by ownership status. Quality scores favored financially integrated systems for four of nine hospital measures and one of nine practice measures, but in no case favored complex systems. Greater financial integration was generally not associated with better quality.
UR - http://www.scopus.com/inward/record.url?scp=85089057485&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089057485&partnerID=8YFLogxK
U2 - 10.1377/hlthaff.2019.01813
DO - 10.1377/hlthaff.2019.01813
M3 - Article
C2 - 32744948
AN - SCOPUS:85089057485
SN - 0278-2715
VL - 39
SP - 1302
EP - 1311
JO - Health Affairs
JF - Health Affairs
IS - 8
ER -