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Should systems buy or build?

An NEJM Catalyst article looks at whether health systems should buy or build to expand. Among the comments:

“As in many industries, health care has experienced waves of consolidation in the name of growth. Hospitals have bought physician practices, doctors are opening ambulatory surgical centers, and there is a buy free-for-all across all parts of the continuum of care (and new forms of payment) as never before. Such vertical integration purportedly drives financial efficiencies with scale, improves clinical quality by reducing problems of care transitions, encourages teamwork, and calibrates scope of practice to services provided. Yet the jury is still out. Costs continue to rise as the market power of health systems grow (with lots of finger pointing), readmissions and problems in patient handoffs persist, anticompetitive practices emerge, and quality remains highly variable.

“Perhaps this lack of progress toward the Triple Aim suggests that we should reconsider our assumptions that vertically integrated systems will achieve productivity, patient-centeredness, and will deliver on a scalable version of Kaiser Permanente. Perhaps we should revisit the so-called rules of health care.”

To read the article, please hit this link.


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