Considerably more physicians joined health systems in recent years, especially in the Midwest and Northeast and in small to midsize markets, according to an article in the latest issue of Health Affairs. Because consolidation tends to lead to higher prices without strong evidence of quality improvements, an increase in consolidation has important implications for policymakers to consider.
Laura Kimmey, a senior researcher at Mathematica, and her coauthors provided new evidence on the rate of physician consolidation into health systems across U.S. markets from 2016 to 2018, using data from the Agency for Healthcare Research and Quality (AHRQ) Compendium of U.S. Health Systems and commercial data on physician-system affiliation. The research team from Mathematica and AHRQ found that physician consolidation into health systems increased in nearly all (92 percent) metropolitan statistical areas from 2016 to 2018. Of the 382 metropolitan statistical areas, 113 had more than half of their physicians in health systems in 2018. Markets with the most growth in consolidation tended to also have sizeable increases in consolidation within the largest system in that market.
The authors encourage policymakers to consider closely monitoring competition at the market level and suggest approaches that might curb costs and anticompetitive practices that could result from increased consolidation. They also encourage further study of the effects of local market consolidation of physician services into vertically integrated health systems on the cost and quality of care and on access to care.
Explore more findings about health systems from Mathematica’s work as the Coordinating Center for the Comparative Health System Performance Initiative.