The remaining 26 articles were selected for full-text review resulting in 16 articles eventually included in the analysis. Nevertheless, some studies argued that less concentrated and high competitive markets report better clinical outcomes in hospitalized patients, i.e. In the meanwhile, hospital managers involved in mergers should adopt a clear evaluation framework with indicators that help to periodically and systematically assess HQM ascertaining that mergers ensure and primarily do not reduce the quality of care. reviews, editorials) and with intervention represented by vertical merger or by non-homogeneous mergers such as those between hospital and non-hospital facilities. The search was carried out until January 2020 using the Population, Intervention, Comparison and Outcome model, querying electronic databases (MEDLINE, Scopus, Web Of Science) and refining the search with hand search. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, GUID:505E7969-EBEC-46AF-A501-22F7CE1AC871. [13], Large hospital systems may fail to improve outcomes and also encourage greater utilization of services; more treatment may lead to sub-optimal care, over-treatment, and can account for higher mortality rates.[14]. [19] Lisa Schencker. Holm-Petersen C, stergaard S, Andersen P.. The merger mania reshaping the Philadelphia regions health care industry over the past few years is evident by the changes at the top of this years Philadelphia Business Journal ranking of the regions largest health systems. Taken from the TapInto Camden, June 5, 2018 Camden, NJVirtuaHealth has signed an agreement to acquire Lourdes Health System from Trinity Health, including Our Lady of Lourdes Medical Center in Camden. Two south Jersey hospital chains announced Thursday they are exploring a merger, a deal that would make them one of the most formidable health care networks in the outer-Philadelphia region. The new health care merger wave: does the Vertical, Good maxim apply? Available at: Comparative analysis of the perception of the advantages and disadvantages of hospital horizontal integration, Employee experience of structural change in two Norwegian hospitals. Another requirement of the ACA involves coordination of care, which hospitals feel will only happen efficiently if there are more hospitals making up a healthcare entity. The https:// ensures that you are connecting to the Hackensack, Meridian merger may lead to new health insurance forays. Modern Healthcare, 17 October 2014,http://www.modernhealthcare.com/article/20141017/NEWS/310179961 Studies included showed methodological heterogeneity, particularly regarding study design and outcomes reporting. MOUNT HOLLY A Superior Court judge has given the green, The proposed deal calls for Virtua to acquire Lourdes and its hospitals, Lourdes Medical Center of Burlington County in Willingboro and Our Lady of Lourdes in Camden, as well as Lourdes nursing school, medical associates and cardiology offices. Studies that assessed HQM of hospitals that have undergone a merger were included. While hospital mergers have been on the rise in recent years, they are not new to the landscape of health care. Regarding stroke mortality, one study28 found a significant negative effect after merger (showing an increase of +4.94% for the acquiring hospital) (table2); two studies2,28 showed that the negative effect of the merger was non-significant (one2 0.055 in logarithmic scale; the other28 +2.42%); on the other hand, eventually, a non-statistically positive effect was found in one study.31 Of the three studies that evaluated hospital readmissions, one31 showed a negative effect of merger, with a statistically significant increase of the 90-day readmission for heart attack, while the other two showed a non-statistical significant positive value of: 28-day stroke readmission rate2 and 30-day readmission rate (0.10 percentage points; 95% confidence interval 0.53 - +0.34; P.72).26. Hello, my name is Patrice Sharkey and I am a nurse at Salem Hospital and a member of HPAE Local 5142, which represents 110 nurses at Memorial Hospital of Salem County. Few studies considered similar outcomes, and when they did, they had either different control group or different methodology of outcome assessment. The Risks of Hospital Mergers. The New York Times, 6 July 2014, http://www.nytimes.com/2014/07/07/opinion/the-risks-of-hospital-mergers.html Studies included in our analysis do not show strong evidence that hospital mergers impact HQM by bringing net improvements. April 1, 2015 By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing All across America, hospitals are merging. While traditional hospital mergers and acquisitions will continue, an uptick in non-traditional alliances will also occur in 2020. The arguments against hospital mergers focus on consumer (patient) costs increasing when there is a dearth of competition: when the same hospital system controls the majority of care in any given area, that system also controls what it charges for services when there is no other system to vie for patients. Study Quality Assessment tools. HQMs were analyzed through a narrative synthesis and a strength of the evidence analysis based on the quality of the studies and the consistency of the findings. Stress levels increase due to multiple changes in systems management, HR management, job insecurity, and newfound employee competitiveness between former competing facilities. Two studies evaluated changes in the number of outpatient visits, one with a non-significant increase30 (2750, t-value 0.07) while the other5 showed a statistically significant negative value in the difference-in-differences analysis (28231.28). Size does matterspan of control in hospitals, Tracking the merger: the human experience. We preferred to synthesize data through a narrative synthesis of the study findings focusing on outcomes of interest reporting statistically significant results. Sapienza Universit di Roma, Roma, Italia, 5 Restructuring and Mergers. In: Hughes, R.G., editor. Regarding structural and process indicators, the reduction in the number of beds and in inpatients admissions (table3) could be related to a structural and functional remodelling of the merged hospitals that seek to pursue economies of scale setting the number of beds at 200300 and keeping the annual discharges at less than 10,000.1,17 Nonetheless, the tendency towards an operational reduction could depend on the pre-merger phase, especially for hospitals that merge due to financial constraints. Virtua announced in June it signed a definitive agreement with Lourdes parent company, Maxis, to acquire Lourdes and its hospitals Lourdes Medical Center of Burlington County in Willingboro and Our Lady of Lourdes in Camden. [15] Xu, supra. Below are some common concerns and/or outcomes when hospitals or hospital systems merge: [1] Robert Pear. Hospitals seeking to understand patient safety strengths and vulnerabilities in the context of mergers/acquisitions benefit more from a third-party perspective than from a limited internal process. This involvement could limit the disadvantages of the organizational change that could undermine clinical outcomes, especially in the short time.31. Kontopantelis E, Doran T, Springate DA, et al. Systematic review of psycho-social factors at work and private life as risk factors for back pain. This data is a powerful new tool for researchers, state and federal enforcement agencies, and the public to . Researchers should work to produce high-quality, well-designed studies with adequate follow-up, in order to evaluate all healthcare quality dimensions (including cost-efficacy and equity) of hospital mergers. Evidence Shows the Opposite, Lourdes Medical Center in Willingboro could become behavioral health, drug treatment hospital, Proposed Virtua-Lourdes merger to proceed without Certificate of Need, Hackensack Meridian Health, Carrier Clinic merger: Projects announced throughout NJ, The Health 202: House Democrats want more aggressive scrutiny of health-care mergers, $60M in investments could save doomed hospital, bring 300 new jobs, When Hospitals Merge to Save Money, Patients Often Pay More, Testimony of Patrice Sharkey of HPAE Local 5142 on Transfer of Ownership of The Memorial Hospital of Salem County, November 8, 2018, Renowned psychiatric hospital acquired by N.J.s largest hospital chain. Recommended for You. Main statistically significant results of single studies, For Romano et al.,28 EH is the acquiring hospital, HPH the acquired hospital. An M.R.I. But the system in place to stop them is often Hackensack Meridian Health has not given up its fight to acquire Englewood Health, despite a federal court order earlier this month. Lifestyle. The 16 articles, included in the narrative synthesis, reported inconsistent findings and few statistically significant results. Evidence from the English NHS patient choice reforms, The impact of competition on management quality: evidence from public hospitals, The impact of hospital mergers on treatment intensity and health outcomes, Efficiency and optimal size of hospitals: results of a systematic search. But they can also be worrisome. 8600 Rockville Pike Policy and decision makers and hospital managers should take into account that a merger should not start without a clear vision and continuous appraisal of benefits, drawbacks and the expected impact of the merger on patients and staff, in an evidence-based policymaking framework that helps to perform an overall periodic assessment of processes and outcomes and to adopt the appropriate corrective measures, whenever necessary. Trinitas Regional Medical Center and RWJBarnabas Health announced on Thursday it has signed a Letter of Intent (LOI) Nearly 3 in 4 hospital markets around the U.S. are "highly concentrated," according to a new Healthy Marketplace Indexreport by the Health Care Cost Institute (HCCI). Marco Mariani and Leuconoe Grazia Sisti contributed equally to this work. Taken from The Philadelphia Inquirer By Harold Brubaker March 1, 2021 Read the article here. government site. [2] Pear, supra. [18], When the FTC attempted to quash a proposed merger between Illinois Advocate Health Care and North Shore University Health System, Debbie Feinstein, the FTCs director of Bureau of Competition, said, This merger is likely to significantly increase the combined systems bargaining power with health plans, which in turn will harm consumers by bringing about higher prices and lower quality.[19]. The research was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guiding the systematic review reporting and was restricted to articles published in English.20. Characteristics of the studies included in the analysis are reported in table1. For perception in staff outcome: in Holm-Peterson et al.,35 satisfaction, leadership tasks, delegation, reflections on size of hospital wards are explored; Cost-reduction benefits, improvement of clinical quality, ability to assume payment risk dimensions are analyzed in Noether et al.32. New Jersey Superior Court Judge Joseph Quinn has accepted New Jersey Acting Attorney General Andrew Brucks approval of CentraState Healthcare System and Atlantic Health Systems plans to expand their successful partnership. Most of the included studies provided only descriptive statistics and some outcomes (benefits or drawbacks) achieved after merging hospitals had been evaluated only in single studies consequently providing little inferential and generalizable information. Based on the reported scale, articles were classified into three levels of RoB: low (76100%), moderate (2675%) or high (025%). [23], A 2014 study found that hospital mergers create an increase in long-term sick absences in the first year and then again 2-4 years after the merger, significantly higher than normal. Elenco Aziende Sanitarie Locali E Strutture Di Ricovero, Hospital centralization and performance in DenmarkTen years on, A strategic document as a tool for implementing change. Do mergers enhance the performance of hospital efficiency? This relies on stylized systems such as electronic patient record tracking and forwarding, for example. Many hospital . First, our research has included only publicly available English-written articles; therefore, a language bias cannot be excluded. The search was refined by hand search performed using Google Scholar, analysis of bibliographic citations and experts recommendation. Background Despite mergers have increasingly affected hospitals in the recent decades, literature on the impact of hospitals mergers on healthcare quality measures (HQM) is still lacking. St. Francis Medical Center, a nearly 150-year-old institution in Trenton, will offer only emergency room and outpatient services starting Dec. 21, under a recently approved merger agreement with Capital Health, officials announced Thursday. Lack of evidence of improved clinical quality after a merger is in line with a new research26 that highlights that mergers do not produce significant differential change in 30-day readmission rates or in 30-day mortality and does find inconclusive improvement in clinical process measures. Consequently, we aimed at systematically review available evidence regarding the impact of hospital mergers on HQM focusing especially on processes indicators and clinical outcomes. Overall, the effects of the mergers could depend on some featuresas the type of the organizations involvedand the merger between similar organizations, sharing the same culture and organizational attitude, appears to be more effective.17 The early involvement and engagement of hospital staff in the pre-merger phase followed by their proper involvement over time26 could also help to ensure the success of the merger, allowing both the structural and the functional integration of the hospitals. Acquired hospitals showed, in one study26, an improvement in the clinical process composite measure (0.22 standard deviation; P = 0.03) but probably not attributable to the merger since the improvement started before the acquisition. The claim was that larger organizations would be able to harness economies of scale and offer better care. New Jersey healthcare system merger would increase price and reduce quality of healthcare. We cannot rule out that the wide variability in the terms used to define merger, as well as the national and governmental dimension of the topic, might have limited the inclusiveness of our research. Supplementary data are available at EURPUB online. Despite this, to date, literature on the impact of hospitals mergers appears to have mainly focused on economic aspects.17 On the other hand, to the best of our knowledge, literature summarizing the impact of merger on HQM is still lacking. 1. FromBeckers Hospital CFO Increased competition and lower state subsidies for charity care are putting pressure on nonprofit hospitals in New Jersey, according to a recent report from Moodys Investors Service. Carrier Clinic, a renowned, century-old psychiatric facility in Somerset County, will merge with Hackensack Meridian Health, the largest hospital chain and healthcare provider in New Jersey Healthcare merger and acquisition deals impact patient access to care and care costs, although its up to debate whether it is for better or for worse. Concerning structure indicators, the change in number of beds after merger showed a decreasing trend: statistically significant decreases in two studies (0.12 on logarithmic scale; 33.98)2,4 and a non-statistical significant decrease in another study (20.7, t-value 0.35) were found.29 Three studies evaluated change in hospital staff number: one2 (table2) showing a significant decrease in total hospital staff (0.12 on logarithmic scale), one9 showing a non-significant reduction in the number of physician employees (19, t-value 0.05), and the other4 a non-significant negative value in the difference-in-difference analysis for total personnel per average daily (35.68). In fact, the study linked hospital mergers and acquisitions to a . Furthermore, NIH tools encompass control group selection criteria and exposure factor items for casecontrol studies, and attrition rate and outcome measures items for beforeafter studies.22 According to The Joanna Briggs Institute Systematic Reviews Checklist,23 congruity among philosophical perspective, research methodology, objectives, methods used to collect and analyze data, interpretation of results and researcher influence on the study were described and assessed for qualitative research. Checklist for Qualitative Research. [20] Marsha Mercer. Will it be enough to turn around an ailing, nearly 100-year-old hospital in rural South Jersey? The trend towards a reduction of the number of staff could be seen in the light of gaining efficiency by increasing hospital productivity. 12 This study also found that this. Cooper University Health Care said Friday it "will no longer pursue the acquisition" of Our Lady of Lourdes Medical Center and other assets of a Catholic-run health system. Hospital Mergers: Creative Solutions. Website accessed 6 January 2016, http://www.mergerwatch.org/creative-solutions/ In case of insufficient evidence, a sensitivity analysis rating the outcome as promising and not promising was also performed. The included studies showed methodological heterogeneity in terms of statistical analysis: five adopted difference-in-differences analysis to compare changes in outcomes in merging hospitals to changes in a group of hospital controls not involved in a merger2,4,5,26,28; two studies16,31 built regression models to account for confounding variables, and in one30 it was possible to extract only the t-test values for the indicators analyzed before and after the hospital merger. Available at: Hoogendoorn WE, van Poppel MN, Bongers PM, et al. As reflected in the Table (see above), most studies of restructuring and mergers have been conducted in acute care settings. Federal government websites often end in .gov or .mil. Hospitals say that the cost of these data collection programs along with the maintenance makes it unaffordable to smaller community hospitals or hospitals that are in financial difficulty; therefore, it is more cost efficient to merge hospitals and maintain one large data system for many hospitals. Add hospital consolidation to the list of health-care problems on which Democrats want to pressure the Trump administration once they take control of the House in January. A planned merger of Saint Luke's Health System with BJC HealthCare of St. Louis isn't about market share, but dealing with economic pressures in the business, local health execs say. As a library, NLM provides access to scientific literature. Results: The primary specification results indicate that merger completion is associated with a 3.7 percent increase in the utilization of bypass surgery and angioplasty and a 1.7 percent increase in inpatient mortality above averages in 2000 for the average zip code. Wary of Mergers by Hospitals. New York Times, 17 September 2014, http://www.nytimes.com/2014/09/18/business/ftc-wary-of-mergers-by-hospitals-.html?_r=0. Damiani G, Silvestrini G, Federico B, et al. Hackensack, Meridian to merge, forming states largest health system. NJBIZ, 16 October 2014,http://www.njbiz.com/article/20141016/NJBIZ01/141019838/hackensack-meridian-to-merge-forming-states-largest-health-system The studies that the FTC's Bureau of Economics (BE) will conduct . Inspira Health announced the addition of Salem Medical Center to its system Dec. 16, acquiring its hospital building, ambulatory surgery center and physician offices, effective immediately. After a decade of "merger mania," many organizations now are taking a step back and looking to unwind past partnerships or call off deals before they are finalized. Cooper University Health announced Thursday it plans to acquire three Catholic hospitals in central and south Jersey, creating the fourth largest healthcare chain in a state in which mergers have become routine business. [12] Vivan Ho and Barton H. Hamilton. After checking for duplicates, 3,662 articles were analyzed for eligibility and 3,636 were excluded after the screening of titles and abstracts. Vogt W, Town R. How has hospital consolidation affected the price and quality of hospital care? [16] Bob Herman. One of the main drivers of health care costs is increasing consolidation among hospitals and hospital systems. Financial Impacts. JFK Health in Edison, one of the last few remaining independent hospitals in New Jersey, will merge with one of the largest health provider chains in the state, according to an announcement by top officials at both nonprofit entities on. Hospital mergers in concentrated markets lead to more significant price increases. Cooper University Health Care and Cape Regional Health System announced that the two systems have signed a Letter of Intent to merge. The focus on hospital monopolies in Minnesota intensified this year, as I wrote before, due to the proposed merger between Fairview, . technologist at the Yale-New Haven Hospital Saint . The Federal Trade Commissionannounced Tuesdaythat two hospital systems in New Jersey that were planning to merge have canceled those plans, following an FTC complaint that a merger would be anticompetitive. However, a tendency in the decrease of the number of beds, hospital staff and inpatient admissions and an increase in both mortality and readmission rate for acute myocardial infarction and stroke emerged in our analysis. The strength of the evidence was performed using a rating system based on the methodological quality of the studies and the consistency of results.24,25 Only outcomes reported in two or more studies were evaluated. They rarely improve access to health care or its. High heterogeneity in the studies methodology was found, e.g. Nonetheless, a tendency towards a worsening includes also other clinical outcomes such as stroke mortality and readmissions. Additional high-quality and well-designed studies with adequate follow-up are needed ascertaining mergers do not reduce the quality of care. Produced and Hosted by A J. Kierstead Joanna Briggs Institute. The boards of VirtuaHealth and Maxis Health System, an. When efficiency becomes the goal, employees may become redundant, with staff layoffs a possibility. Impact of hospital mergers on staff job satisfaction: a quantitative study. Human Resources for Health, 2014, 12:70,http://www.human-resources-health.com/content/12/1/70 Every year, New Jerseys health care system moves one merger closer to making independent hospitals a relic of the past. Have a question? Despite this, to date, literature on the impact of hospitals mergers appears to have mainly focused on economic aspects. April 14, 2021. Conversely, personnel expressed criticalities mainly regarding the different organization of merged hospitals, the inadequate communication of the merger process, the uncertainty of job positions and the lack of personnel involvement in the post-merger phase. The literature suggests that hospital mergers, particularly facility-level mergers, are capable of attaining substantial cost savings (Connor et al. While these cases are quite prominent in healthcare news of late and make it appear an FTC challenge is a common occurrence, Edith Ramirez, then chairwoman of the commission in 2014, said the FTC had challenged less than 1 percent of hospital deals. Respect to the volumeclinical outcome relation, it is reported to widely vary across conditions and outcomes, with the largest benefits occurring among a small number of technically difficult surgical interventions.17 Studies included in our research did not reach sufficient strength of evidence towards a clear improvement or worsening; only one study28 showed a statistically significant worsening in relation to stroke and AMI mortality. HPAE members testifed at two public hearings held yesterday to review the proposed merger of the Hackensack University Health Network and Meridian Health. [10], Womens access to reproductive healthcare services may be curtailed if a merger occurs between a secular hospital and a Catholic hospital system unless a carve-out is requested that will protect patients rights to accessing comprehensive reproductive health services. Noether M, May S. Report: Hospital Merger Benefits: Views from Hospital Leaders and Econometric Analysis, January 2017, reported by American Hospital Association (AHA). the contents by NLM or the National Institutes of Health. in measures used to evaluate results and in the follow-up duration (from months to years), hindering undertaking a formal meta-analysis and performing a rigorous strength of evidence analysis. Richardson WS, Wilson MC, Nishikawa J, et al. Studies analyzed in our research show that, apart from some structural and process indicators, hospital mergers resulted in non-significant improvement in the HQM compared to the period before the merger itself. Want to update your information or join HPAE? The proposed health insurance mega-merger between Anthem and Cignaheads to court on Monday, as the companies face off against a Justice Department seeking to block their $48 billion deal. THE IMPACT OF THE INSURER PERSPECTIVE ON STANDARD MARKET DEFINITION IN HOSPITAL MERGERS Economists and antitrust practitioners generally use a two-stage model to examine competition between. F.T.C. By Elsa Pearson Reprints Adobe C ontrary to what health care executives advertise, hospital mergers and acquisitions aren't good for patients. increasing or decreasing of the same indicator in different studies), we performed a strength of evidence analysis according to literature.24,25. The short-term effects of merger on hospital operations, Hospital consolidation and costs: another look at the evidence, Ministero della Salute. A federal appeals court on Tuesday blocked the proposed merger of Englewood Health and Hackensack Meridian Health. At all levels, disagreement and discrepancies between the investigators were solved by consensus. How Hospital Mergers Increase Health Costs, and What to Do About It. Forbes, 1 March 2012,http://www.forbes.com/sites/theapothecary/2012/03/01/how-hospital-mergers-increase-health-costs-and-what-to-do-about-it/ The database research resulted in 4,709 records while 4 articles were retrieved through hand search. Hospital mergers and acquisitions: does market consolidation harm patients? Journal of Economic Health, Volume 19, Issue 5, pp 767-791, September 2000. Rockville (md): Agency for Healthcare Research and Quality (US); 2008 Apr. Many of the purported benefits of hospital mergersincluding coordination of patient care, sharing information through electronic medical records, population health management, risk-based contracting, standardizing care, and joint purchasingcan often be achieved through alternative means that do not impair competition. New Jerseys Attorney General is required to schedule hearings where the public can testify about the merger. On January 14, 2020, the Federal Trade Commission (FTC) ordered six insurance companies to provide information that will allow the agency to study the effects of consummated physician group and healthcare facility mergers that occurred from 2015 through 2020. The well-built clinical question: a key to evidence-based decisions, Defining and classifying clinical indicators for quality improvement, PRISMA Group. Waves of mergers and acquisitions among the players in U.S. health care have already led to higher prices, and there is little evidence that they . By far, the preponderance of empirical evidence relates to the price impacts of mergers and acquisitions that increased hospital concentration in fairly tightly-drawn local markets.a These studies cover a range of years and use a variety of methods, but almost without exception they demonstrate that prices increase following hospital consolidation in the market. Similar findings are reported by the American Hospital Association in a study32 that stressed that, apart from the substantial quality benefits noted by hospital leaders, small positive improvements are reported, above all in readmission rates. The effect of hospital mergers on long-term sickness absence among hospital employees: a fixed effects multivariate regression analysis using panel data. BMC Health Services Research, 2014, 14:50, http://www.biomedcentral.com/1472-6963/14/50 This systematic review represents a first attempt to summarize evidence regarding the impact of hospital mergers on HQM with the purpose of providing a broader picture regarding research and practice on hospital merging processes. No follow-up, not being seen, role overload, but they also report more development possibilities and greater flexibility, Saving in fixed costs especially associated with supply chain, IT, administration, billings, pharmacy and laboratory and physical plant management. Process and impact of mergers of NHS trusts: multicentre case study and management cost analysis, Changing organisations: a study of the context and processes of mergers of health care providers in England, Does hospital competition save lives? [26]. Nonetheless, several limitations could be identified. [17], A 2014 New York Times editorial board opinion noted the increasing prices for services after Massachusetts General and Brigham and Womens Hospitals merged, as well as purchasing domination of doctors practices; Massachusetts AG attempted to rein in costs and bargaining power through a negotiated deal. [7] Tamara B. Hayford.The Impact of Hospital Mergers on Treatment Intensity and Health Outcomes. Congressional Budget Office, Working Papers Series, October 2011, https://www.cbo.gov/sites/default/files/112th-congress-2011-2012/workingpaper/10-06-2011-Hospital_Mergers_1.pdf AHRQ: Agency for Healthcare Research and Quality; EH: Evanston Northwestern Hospital; ER: Emergency Room; HPH: Highland Park Hospital; IT: Information Technology. BJC, Saint Luke's announce plans to form $10 billion system. The Centers for Medicare & Medicaid Services (CMS) is releasing data publicly -- for the first time -- on mergers, acquisitions, consolidations, and changes of ownership from 2016-2022 for hospitals and nursing homes enrolled in Medicare. Millions in investments. The sensitivity analysis did not show promising results with the exception of the decrease in the number of beds and in the inpatient admissions (table3). As with the 2008 financial crisis when large banks were bailed out with taxpayer money, too big to fail, hospital system failures could become the financial burden of the communities with a similar bailout plan for the hospital system. Furthermore, we sought to increase the value and the validity and reliability of findings performing strength of evidence analysis. One analysis found that prices at hospitals acquired by outofmarket hospital systems increase by about 17% more than unacquired, standalone hospitals. Site designed and developed by Social Ink, Campaign for Patient Safety and Safe Staffing, NJs only Public Hospital Needs a State-of-the-Art Medical Campus, Attorney Referral for NJ Workers Compensation, Collective Bargaining Agreement between HPAE and United Methodist Communities, Inspira Health adds Salem Medical Center to network, 150-year-old N.J. hospital will merge with Capital Health, offer only ER and outpatient care, Cooper University Health, Cape Regional Health sign LOI to merge, New Jersey hospital to close under proposed deal, FTC blocks merger of two NJ hospitals less than a mile apart, Merger plans abandoned: Hackensack Meridian, Englewood Health terminate agreement, US court blocks merger of Hackensack Meridian and Englewood Health, Expanded Partnership Between CentraState Healthcare System and Atlantic Health System Approved by State of New Jersey, The downsides of merger mania in healthcare, 25 attorneys general urge court to block New Jersey hospital merger. [8], Quality of care improves under tougher competition, as well as under an administered pricing system (Medicare/Medicaid). Last night a dozen HPAE members and staff attended a public hearing on the affiliation of JFK Medical Center with Hackensack Meridian Health (HMH). Many things affect your health. Studies included in our systematic review resulted to be heterogeneous in HQM analyzed and methodology adopted mainly providing only descriptive statistics and showing moderate to low risk of bias, few statistically significant results and inconsistent findings across them. strong evidence: provided by generally consistent findings in multiple high-quality studies; moderate evidence: provided by generally consistent findings, in one high-quality study and one or more moderate-quality studies or in multiple moderate-quality studies; and. official website and that any information you provide is encrypted In recent years the Federal Trade Commission has challenged several hospital and/or doctor practice mergers, and the courts have made the mergers unwind even after the merger has been completed. Increase: n. of doctors (19.25%), number of nurses (13.19%) and other healthcare professionals (19.14%), Decrease: number of social and healthcare assistants (16.74%), Increase: mean time waited per admission (+0.10). 7,8 For instance, acquiring hospitals might transfer managerial, clinical, or. Regarding process indicators, three studies2,4,5 showed a statistically significant decrease in inpatient admission (0.11 in logarithmic scale; 743,47; 6289.35) (table2). The reasoning is that more providers make for greater competition and therefore lower prices. The Potencial Hazards of Hospital Consolidation: Implications for Quality, Access, and Price. JAMA, Volume 314, No. It's over. The majority (56.3%) were developed in the USA, followed by Northern Europe (Norway, Denmark, Sweden) accounting for 31.3% of all studies. CRICO's Risk Assessment Unit has access to a rich body of work to help articulate identified factors and by which to frame improvement recommendations. Accessibility The environment in which you live and work. Published May 21, 2021 Updated Oct. 22, 2021 Billions of dollars in Covid aid cushioned financial losses caused by the pandemic at some of the nation's largest hospital chains. Hospital mergers between similarly-sized organizations are driving the recent increase in healthcare mergers and acquisitions. Evidence Shows the Opposite. Hackensack Meridian Health Wednesday announced it now owns JFK Medical Center in Edison, a deal that creates the largest hospital chain in New Jersey. Lessons from the merger creating the South-East Health region in Norway, Big business: the corporatization of primary care in the UK and the USA. On April 27, 2018, the United States Senate confirmed President Trumps five nominees for Commissioners of the Federal Trade Commission (FTC). To gather evidence on the impact of hospital merger on HQM, a search string was elaborated using the Population, Intervention, Comparison, Outcome (PICO) model.18 In detail, we identified the population as hospital facilities, the intervention as the merger, the comparator as non-merged hospital or the same hospital in the pre-merger status, and the outcome as structure, process and outcome HQM.19 Search strings were built using the following keywords: hospital, merger, consolidation, outcome, process, indicators, performance, measure (Supplementary data). The quality of care. Hackensack Meridian and Englewood Health fight on in favor of hospital merger, Deal off for now: Federal judge halts Hackensack Meridian acquisition of Englewood Health, Thomas Jefferson University says the FTC has dropped opposition to its acquisition of Einstein, FTC Challenges Hackensack Meridian Health, Inc.s Proposed Acquisition of Competitor Englewood Healthcare Foundation, RWJBarnabas, Trinitas clinch definitive merger agreement, FTC challenges Jefferson-Albert Einstein hospital merger, Not every N.J. hospital sees need to merge into bigger system but independents are dwindling, RWJBarnabas, Saint Peters Healthcare to explore merger, Health Cares Biggest Problem Is Getting Worse, Merger mania shakes up Philadelphia-area health system rankings, RWJBarnabas to buy Christ Hospital and Hoboken University Medical Center, HPAE Calls for Oversight and Transparency as Englewood Health merges into Hackensack Meridian Health, NJs Largest Healthcare Corporation, Englewood Medical, one of last independents in region, to merge with Hackensack Meridian, Trinitas signs LOI with RWJBarnabas Health to join system, Report: 3 in 4 hospital markets are now highly concentrated, Judge OKs Virtua acquisition of Lourdes Health and its hospitals, NJ AG recommends Virtua-Lourdes deal move forward, One of N.J.s largest hospital chains looking to expand its turf with another big merger, Hospital Mergers Improve Health? The nations hospitals have been merging at a rapid pace for a decade, forming powerful organizations that influence nearly every health care decision consumers make. Summary. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. insufficient evidence: inconsistent findings in multiple studies. NS, non-significant; +: statistical significant increase of outcome in merged hospitals; : statistical significant decrease of outcome in merged hospitals; EH: Evanston Northwestern Hospital; FTE: full time equivalent; HPH: Highland Park Hospital; AHRQ: Agency for Healthcare Research and Quality Indicator. The .gov means its official. Today, health care is unaffordable for too many families. How can it be assessed? [4] Dr. Mary Campagnolo, president of the Medical Society of New Jersey, stated that doctors would be making more data-driven decisions for patients. [1] When the FTC feels unequivocally that a merger between two systems, two hospitals, or even between a hospital and a doctor group practice threaten the likelihood of healthy competition, they will intercede. UPMC's rollup entailed ruthless downsizing measures to cut costs, including closing down four hospitals entirely and stripping out services in rural areas, such as maternity wards. In theory, with greater efficiency hospitals may provide more care while lowering the cost of care. [3] Andrew Kitchenman. Despite mergers have increasingly affected hospitals in the recent decades, literature on the impact of hospitals mergers on healthcare quality measures (HQM) is still lacking. Director of the Federal Trade Commissions bureau of economics Martin S. Gaynor said, Hospitals that face less competition charge substantially higher prices. He noted that the price increases could be as high as 40 percent to 50 percent.[21], Associate professor of economics at Clemson University Matthew S. Lewis stated, Acquisitions of hospitals by large national chainsmay not increase hospital concentration in the affected local markets, but could nevertheless generate higher prices.[22], An article in Forbes noted that concentrated hospital markets can increase prices by as much as 44 percent. Need to long-term commitment, organizational change and consolidation of hospital services and cultural change, Goal uncertainty and distance between decision makers and employees, strong differences in culture of the two hospitals and fear to be ruled by the other hospital, individual insecurity of professional positions reached, Increase: AMI mortality (AHRQ): EH (+4.96); Pneumonia mortality: EH (+3.14); Stroke mortality: EH (+4.94); Post-operative hip fracture: EH (+0.09); Birth trauma: HPH (+0.33%) EH (+ 0.74%); Neonatal mortality EH (+0.32); Decrease: Obstetric trauma HPH (1.14%) EH (1.08%); Decubitis ulcers HPH (0.76%) EH (0.56%), Selected infections due to medical care: EH (0.05%), Cultural differences between hospital merged. The impact of hospital consolidation Update. Robert Wood Johnson Foundation, June 2012,http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2012/rwjf73261 [25] Ka Keat Lim. Mergers may affect delivery and availability of services as hospitals work toward greater efficiency in cost control. She noted that if done right It should drive down costs, [and] if its not doing that, then were probably not doing the right things[for] a much more efficient state of healthcare.[5] Are these the scenarios you want for the future of NJ healthcare? Since that time, the literature has expanded a great deal. But will some communities lose out in the new healthcare landscape? A new name. In the last decades, an increasing number of hospitals have undergone a merger but literature on the impact of merger on hospitals Health Quality Measures (HQM) is still lacking. Ethical approval and researchers cultural or theoretical orientation were not reported in all of qualitative researches; only one35 qualitative study considered researcher influence on the research. Threat of layoffs, especially for the employees whose facility is taking the subordinate role. Inclusion in an NLM database does not imply endorsement of, or agreement with, Our estimates indicate that the aggregate impact of hospital mergers is modest but not trivial. Personnel interviewed were mainly represented by different healthcare professional staff (71.4%), while two studies32,33 specifically focused on chief executives. How Do Healthcare Mergers and Acquisitions Impact Patients? resulting in $5.8 million in savings at each acquired hospital. Taken from NJ.com BySusan K. Livio March 21, 2019 Trinitas Regional Medical Center in Elizabeth is in confidential negotiations to join one of the states largest hospital systems, continuing a decade-long frenzy of mergers in New Jerseys fierce healthcare market. St. Francis Medical Center in Trenton, N.J., would close and many of its services would be shifted to another hospital if a proposed transaction between Capital Health and Trinity Health is approved, according to the Philadelphia Business Journal. 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While lowering the cost of care be able to harness economies of scale and offer better care was refined hand! Recent increase in healthcare mergers and acquisitions: does market consolidation harm patients that you are connecting the! Work toward greater efficiency in cost control since that time, the literature that... Heterogeneity in the light of gaining efficiency by increasing hospital productivity absence among hospital:... Relies on stylized systems such as stroke mortality and impact of hospital mergers could limit disadvantages... Where the public to that concentrated hospital markets can increase prices by as much as percent!