Category: consolidation
About 73% of health insurance markets are highly concentrated, and in 46% of markets, one insurer had a share of 50% or more, a new report from the American Medical Association shows. The report comes a few months after President Joe Biden directed federal agencies to ramp up oversight of healthcare consolidation.
Independent physician practices are being gobbled up by hospitals, payers and private equity, and while some see it as a boon for the practices and industry as a whole, others believe it will raise costs and block access to care.
President Joe Biden has signed a new executive order to tackle anti-competitive behavior across American industries. With regard to healthcare, Biden is directing federal agencies to revise guidelines for hospital mergers, enable people to comparison shop health plans on the ACA marketplaces and work with states to import drugs from Canada.
M&A activity in the healthcare finance technology is heating up, evidenced by large transactions such as Cedar buying OODA Health and R1 RCM buying VisitPay. Experts agree that this activity won’t end anytime soon, and it will have a positive impact on providers and patients.
As a result of rapid consolidation, the 10 biggest health systems controlled 24% of market share based on patient revenue by 2018. The trend is expected to continue through the next decade, with health systems facing growing financial pressures and an increase in demand for new types of care delivery.
If the merger is approved, the combined health system would operate 70 hospitals and employ 89,000 people. Intermountain CEO Dr. Marc Harrison would lead the new system, estimated to generate about $15 billion in annual revenue.