The group, writing in the Aug. 13 JAMA, warn that hospital c0nsolidation into large chains reduces competition that can improve care and control prices, gives patients fewer choices and could result in higher overall and individual medical expenses.
The authors want the FTC to pay particular attention to mergers that could result in creating one dominant hospital system in a region. There were 193 mergers in 2013 and 2014 and about about a fifth of U.S. hospitals are expected to seek a merger in the next five years, the authors found.
A 2013 analysis, also published in JAMA, found that none of the 306 geographic healthcare markets in the United States are considered highly competitive. Single systems dominate nearly half of these markets.
The authors said that “limited integration” has benefits, such as when large medical centers collaborate with smaller community hospitals to improve patient care.
Robert Wood Johnson Foundation research found that patients living in competitive healthcare markets have better medical outcomes and lower death rates than people in less competitive ones.