Hospital Consolidation: Can It Work This Time?

One of the consequences of the Affordable Care Act (ACA) is that it has sparked a giant wave of hospital consolidation: 100 deals were completed in the sector in 2014 — up 14% from the previous year, according to Wall Street research firm Irving Levin Associates.

What’s particularly notable about the recent spate of M&A is that it’s both “horizontal” and “vertical,” meaning hospitals aren’t just buying other hospitals, they’re picking up physician practices, rehabilitation facilities and other ancillary health care providers. Consider New York’s North Shore-LIJ, for example. Its aggressive M&A plan has turned it into the state’s largest employer, encompassing 18 hospitals, plus rehab centers, a medical research center, home-care services and hospice facilities. And last year it began offering health coverage through its own insurance company, CareConnect.

Wharton’s health care experts predict the trend of hospital consolidation will continue at a fast clip, particularly as health systems set up more and more Accountable Care Organizations (ACOs) in response to the ACA.

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What Exactly Is An Integrated Healthcare Delivery System?

What exactly is an integrated healthcare delivery system is a question we are asked fairly regularly. Even today, many individuals are not sure what the term refers to.

(We know because we produce the National Directory of Health Systems Hospitals and Their Affiliates Database.)

What callers have trouble grasping is the ‘affiliate’ piece. There are more than 11,500 affiliates that are a significant part of the health system.

We call the health systems the ‘motherships’ and all the affiliates are under the health system umbrella.

To be recognized as a true integrated healthcare delivery system or network – your preference – industry experts agree there must be a number of key elements present, including the philosophy of a “systemness” — certain system-wide functions and decision-making authority.

There must be a common philosophy among network entities to provide a “seamless continuum of care” — the opportunity to offer the community or region expanded and complimentary health services, and elimination of duplicative service programs.

To achieve this “seamless continuum of care” an integrated healthcare delivery system must provide a full range of healthcare services to a market area that is comprised of physicians, clinics, hospitals, a referral network, and a diverse offering of after-care services.

An integrated healthcare delivery system may operate its own managed care organization (MCO) or may wholesale the provision of care services and seek to accept risk within components of the systems, such as a physician network or its hospitals.

The National Directory of Health Systems, Hospitals and Their Affiliates Database is researched, compiled and produced by the Managed Care Information Center.

Our database provides key contact information, names, addresses and other details on the more than 750 major health systems in the United States, the almost 3500 health systems hospitals and more than 11,700 hospital system affiliates.