An article by Attebery et al. entitled “Better Together? An Examination of the Relationship Between Acute Care Hospital Incorporation and Patient Experience” published in Journal of Health Management (Attebery, Hearld, Carroll, Szychowski, & Weech-Maldonado, 2020) explores the effect of the current wave of hospital mergers on patient experience. The article argues that hospital mergers are closely related to the Hospital Consumer Rating of Healthcare Providers and Systems (HCAHPS) score, and suggests that their findings can be used as a guide for hospital administrators, health system board members, policy makers, and other stakeholders. other health. when making the decision to merge their hospital or healthcare system with another. Adequate analysis and review of this article requires a summary of its contents and personal analysis, supplemented by sound predictions.
The prevalence of healthcare mergers, acquisitions, and multiple integrations and alignments is becoming ubiquitous, and for the foreseeable future, industry experts have forecast a continuing trend. According to the article, hospital systems join forces to achieve some sort of tangible advantage for their organizations, whether it’s additional resources, protection, or avoiding bankruptcy and closure. Ultimately, hospitals and health systems join forces to continue access and delivery of health services to their local communities. As a strategic choice, one would expect that the combination of assets and resources generated through a merger would enhance the combined organizations’ ability to meet the healthcare needs of patients in their respective communities, but empirical evidence suggests that, across industries, mergers often fail to deliver. this purpose. Several similar studies have attempted to answer the question, “Do hospital mergers generate healthcare value?” While this research measures the value of healthcare using the price, efficiency, quality, and safety of hospitals as a result, this article attempts to answer this question by examining the effect of hospital aggregation on patient experience. Patient experience, including patient preference, physician choice, and various HCAHPS reporting scores, has recently become a priority for hospitals, as higher patient experience ratings translate to improved reputation and financial performance. Using a retrospective quasi-experimental design that compared patient experience scores between hospitals resulting from a merger with hospitals that had “matched a propensity score” that had not yet undergone a merger, the authors found a year-over-year increase in HCAHPS scores for the merged hospitals over 3- years of the pre-merger period, but significantly reduced rates of improvement in HCAHPS scores for post-merger merger hospitals when compared to score-matched control hospitals. This is especially true of “overall patient experience” and “nurse communication”. This led the authors to conclude that hospital mergers have a negative impact on hospital performance and patient experience (Attebery et al., 2020).
While the authors demonstrated a slight reduction in patient experience growth after the merger, they were unable to demonstrate any effect on patient outcomes or a clear reduction in post-merger patient experience scores. Hospital matched scores used in this study did not control for differences by geographic region and the lack of available HCAHPS data. Additionally, the authors did not address the potential adverse effects of hospital closures on healthcare access, patient outcomes, and patient experience. I also believe that the authors have not established sufficiently why patient experience should be considered as a factor in determining whether to proceed with consolidation. I expect more hospital mergers, acquisitions, integrations and other forms of alignment to continue into 2021 and 2022, as the COVID-19 pandemic continues to strain the economy and the ability of hospitals to recover revenue losses from reduced elective procedures, even if positive. overall 3rd quarterly GDP growth. In addition, independent practicing physicians who cannot offset revenue losses caused by public fear of healthcare arrangements will likely seek to consolidate with larger healthcare institutions that can sustain more revenue losses. With increasing cases of COVID-19, increasing reuse of inpatient areas for COVID-19 management, and the economic uncertainty created by the potential for hospital restrictions, future closures, and a second COVID-19 stimulus that is increasingly unlikely in the near future, I predict that the healthcare market will continue to consolidate to protect the healthcare industry and the ability of healthcare organizations to provide access to the sickest individuals.
Reference
Attebery, T., Hearld, LR, Carroll, N., Szychowski, J., & Weech-Maldonado, R. (2020). Better together? Examination of the Relationship Between Acute Care Hospital Affiliation and Patient Experience. Journal of Health Management, 65(5), 330-343. doi:10.1097/jhm-d-19-00116
