Over 70% of physicians are now employed by a health care system or corporate entity, including publicly traded and private equity firms. Research to date shows that consolidation has increased health care prices with limited impact on quality or access to care. Yet the impact of consolidation is highly heterogeneous across market conditions. Research at CAHPR aims to inform policy by understanding this evolving landscape that has critical implications for competition, choice, access, and the structure of health care services.
Center for Advancing Health Policy through Research
Markets and Consolidation
While the health care industry has been consolidating for two decades, a number of trends are changing how physician markets are organized and how various stakeholders are impacted.
Recent News
The New Yorker
The Gilded Age of Medicine Is Here
This article dives into the controversial world of private equity in healthcare, where profit-driven strategies lead to higher patient costs and declining care quality. This article examines real examples, from staffing cuts to surprise billing, and explores how these changes threaten physician autonomy and the stability of U.S. healthcare.
Health Affairs Forefront
California’s Failed Bid To Regulate Private Equity Investment In Health Care
The article examines California’s failed attempt to regulate private equity investments in healthcare through AB 3129, which proposed stricter transaction oversight and protections against corporate control of medical practices. It critiques the bill’s limited scope, exemptions, and political challenges while positioning it as a case study for future state-level reforms in addressing healthcare consolidation.
This article highlights a study by Christopher Whaley showing how hospitals have received billions in extra payments by documenting care at higher levels of complexity than expected. This practice, known as "upcoding," raises concerns about the incentives in current payment systems and their impact on rising healthcare costs.
The article written by CAHPR researchers, emphasizes the opportunity for Congress, in its final weeks of the 118th session, to advance healthcare affordability and transparency through the Lower Costs, More Transparency Act (LCMT) and the Health Care PRICE Transparency Act 2.0
UnitedHealth Group's insurance arm, UnitedHealthcare, pays its own Optum physician practices significantly higher rates than other providers in the same markets, driving up costs for consumers and employers while enriching itself. This practice highlights the conflicts of interest and anti-competitive effects of vertical integration in healthcare, raising calls for regulatory intervention.
Turn on the Lights Podcast
Health system ownership with Hayden Rooke-Ley
Is Medicare Advantage improving healthcare efficiency or creating higher costs that favor insurers? Hayden Rooke-Ley explores its rapid expansion, questions about cost and care quality, and the challenges of implementing effective regulations.
The Oregonian/OregonLive
Oregon regulators plan deep dive on OHSU-Legacy merger: 6 things to know
This article outlines six key points about Oregon's regulatory review of the OHSU-Legacy merger. Hayden Rooke-Ley's critique of the OHSU-Legacy merger, emphasizing how OHSU's broad market definition may obscure significant anticompetitive risks, presenting a critical test for Oregon's Health Care Market Oversight program.
Portland Business Journal
OHSU-Legacy merger: Regulators explore antitrust concerns
This article examines the Oregon Health Authority's comprehensive review of the proposed merger between OHSU and Legacy Health, highlighting key concerns about market concentration, potential cost increases, and the future of health care access and competition in the region.
The American Prospect
Are Democrats Even a Little Serious About Stopping Private Equity?
The article exposes Ralph de la Torre's misuse of private equity-backed Steward Health for personal gain while highlighting the broader issue of private equity's damaging impact on healthcare, with legislative efforts for reform largely stymied by political and lobbying pressures.
This article explores how private equity firms have taken control of many U.S. emergency rooms, prioritizing profit by reducing physician hours, replacing doctors with less qualified staff, and inflating costs, resulting in compromised patient care and increased bills, despite regulatory efforts like the No Surprises Act.
Health Affairs Forefront
The Rise Of Health Care Consolidation And What To Do About It
CAHPR researchers examine the economic and healthcare implications of consolidation within the U.S. healthcare system while proposing legislative solutions aimed at curbing the adverse effects of consolidation.
Health Affairs Forefront
The FTC's Noncompete Rule: Legal Challenges And Potential Solutions For Physician Markets
The FTC's nationwide ban on non-compete agreements, originally set to take effect on September 4, 2024, is now entangled in legal battles that challenge the agency's authority. This article explores the ongoing debates, highlighting the loopholes in the current rule, and prescribes potential policy solutions.