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Spotlight on Integration Demands Deeper Understanding of Its Value

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Last week, during a hearing of the U.S. Senate Antitrust Subcommittee, lawmakers on both sides of the aisle took aim at hospital consolidation, whose perception as a driver of health care costs — despite thin evidence — is growing. 

This is an unfortunate and worrying belief among politicians — both at the federal and state level — because those who operate hospitals and are committed to ensuring high-quality care and access know that health care systems provide great value and indispensable resources that might not be available otherwise. 

One need look no further than the ongoing COVID-19 crisis to understand how health care systems — uniquely — saved lives during the pandemic. Health care academics and futurists Jeff Goldsmith and Ian Morrison captured this concept in a March 2021 article in Health Affairs, writing: 

“Just like the proverbial auto accident witness who rushes into the intersection and lifts the front end of a car off an injured child, health systems achieved things in the height of the pandemic that no one believed possible…. both of us have been convinced by the last twelve months that health systems’ scale was a major societal benefit in coping with COVID. Over this period, health systems have demonstrated that they are a vital part of our public health infrastructure. While the public benefits of health systems are difficult to quantify, they have performed far better than just about any other element of our society in responding to COVID.” 

Rod Hochman, MD, president and CEO of Providence St. Joseph Health and American Hospital Association (AHA) board chair, reinforced the value of systems as he delineated their benefits during his testimony at last week’s hearing

Some critics are quick to dismiss the benefits of hospital mergers and acquisitions. As a physician with over four decades of experience caring for patients, I can tell you that integration is the key to ensuring every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced-based care. The ability of health systems to marshal financial and human resources during the pandemic to save lives and protect communities illustrates vividly their enduring value. And unlike other sectors of health care, communities can be assured that there is vigorous oversight by every level of government to assure those benefits are actually delivered to the patients hospitals and health systems serve. 

These concerns at the federal level are shared by California’s legislators. A bill introduced this year (AB 1132, Wood) would have introduced onerous barriers to hospitals’ ability to form relationships — both among hospitals and with other health care entities. That bill has been moved to 2022, but we will continue to educate legislators about the benefits of integration ahead of formal debates next year (AHA also has resources to share this important story).  

As this conversation continues to unfold, there’s one thing we know for certain and will continue to reinforce with legislators: Integrated health care systems are part of the fabric of California’s, and the nation’s, health care system, and in many cases are solely responsible for the ability to provide care in rural and underserved areas. Integration will remain a vital tool for hospitals and health systems as they continue to transform themselves to meet the needs of their patients and the communities they serve. 

~ Carmela