Bigger hospitals, higher prices

Giant health systems cost more but provide no better care; there is a better way, argue experts SHANNON BROWNLEE and VIKAS SAINI

Post-Gazette.com   February 22, 2014 6:32 PM 
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Hospitals are busily merging with other hospitals and buying up groups of doctors. They claim that size brings efficiency and the opportunity to deliver more “value-based” care — and fewer unnecessary services. They argue that they have to get bigger to cut waste. How much evidence exists that bigger hospitals offer better value? Not a lot.

If you think of value as some combination of needed services delivered for the right price, large hospitals are no better than small hospitals on both counts. The Dartmouth Atlas of Health Care and other sources have shown time and again that some of the biggest and best-known U.S. hospitals are no less guilty of subjecting patients to useless tests and marginal treatments.

Larger hospitals are also very good at raising prices. In 2010, an analysis for the Massachusetts attorney general found no correlation between price and quality of care. A study published recently in Health Affairs offered similar results for the rest of the country: On average, higher-priced hospitals are bigger, but offer no better quality of care.

The disconnect between price and value has many causes, but the flurry of mergers and acquisitions in the hospital industry is making it worse. Hospitals command higher prices when they corner market share. They gain even more leverage when they gobble up large physician practices.

Read more: http://www.post-gazette.com/opinion/Op-Ed/2014/02/23/Bigger-hospitals-higher-prices-1/stories/201402230008#ixzz2vBdbL9mo

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