Study Finds Hospital Mergers Failed to Improve Quality of Care

Research published in the New England Journal of Medicine found that the recent wave of health care mergers and acquisitions had no substantial impact on quality of care, with levels mostly declining or staying the same. The findings call into question hospital executives’ claims that such transactions boost quality through new investments and shared resources.

In this analysis, investigators searched for evidence of improved quality at nearly 250 hospitals involved in transactions between 2009 and 2013. The authors measured patient satisfaction, 30-day mortality, 30-day hospital readmission rates, and how often some heart, pneumonia, and surgery patients received guideline-recommended care.

Researchers examined the average results in these categories for acquired hospitals in the 3-year period before and the 4-year period after each transaction, comparing them with hospitals not involved in transactions.

“Quality didn’t improve [after mergers],” lead author and Harvard University research associate Nancy Beaulieu, PhD, told The Wall Street Journal. On average, patient satisfaction scores – which measure whether patients would give hospitals a good rating and recommendation – worsened at acquired hospitals, particularly those that already had lower patient satisfaction scores prior to the transaction.

Return trips to the hospital and rates of death remained the same before and after acquisitions, and results were inconclusive regarding how often heart, pneumonia, and surgery patients received recommended medical care.

Mergers and acquisitions among hospitals have soared in the past decade, from 50 transactions in 2009 to a high of 117 transactions in 2017. However, there was a dip in 2018, when 90 mergers and acquisitions were announced.

Sources: The Wall Street Journal, January 1, 2020; Beaulieu ND, Dafny LS, Landon BE, et al. Changes in quality of care after hospital mergers and acquisitions. N Engl J Med. 2020;382:51-59.