/ en Thu, 31 Jul 2025 02:45:41 -0500 Tue, 17 Jun 25 06:15:00 -0500 /aha-center-health-innovation-market-scan/2025-06-17-4-keys-successful-post-merger-health-system-integration <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/4-Keys-to-a-Successful-Post-Merger-Health-System-Integration.png" data-entity-uuid="f73c3136-baca-4316-a852-836c77848ef6" data-entity-type="file" alt="4 Keys to a Successful Post-merger Health System Integration. Market Scan Trailblazers: Assembly Required. An Operator's Manual for Post-merger Integration. Sponsored by: Guidehouse. Download the report." width="900" height="508"><p>Building an integrated hospital or health system after a merger can be complicated. After all, hospitals and health systems arguably are among the most complex, sophisticated organizations.</p><p>Yet, the general steps taken to successfully integrate hospitals and health systems are strikingly similar to the steps and concepts required to build a shelving unit, for example.</p><p>A new AHA Market Scan Trailblazers report, <a href="/aha-center-health-innovation-market-scan/2025-06-16-hospital-operators-manual-post-merger-integration" target="_blank" title="Trailblazers Assembly Required: An Operator’s Manual for Post-merger Integration">“Assembly Required: An Operator’s Manual for Post-Merger Integration,”</a> outlines a 10-step approach to this process. The report includes case studies on how Henry Ford Health and USA Health each handled post-merger integration in their respective systems as well as insights from Guidehouse, a health care consulting firm that sponsored the report.</p><h2>4 Keys to a Successful Post-merger Integration</h2><h3><span>1</span> <span>|</span> Begin with the end in mind.</h3><p>Anyone who’s ever tried to put together a shelving unit, a piece of office furniture or rolling kitchen island from IKEA knows that the cover or first page of the assembly instructions is always a picture of what the item is supposed to look like once it’s completed.</p><p>It’s no different for hospitals or health systems that have just signed a merger or acquisition agreement. Both sides must be aligned on the mission, vision and values of the consolidated organization as well as how it will function and operate after the integration. The shared vision of a successful integration will serve as the North Star to keep the newly consolidated organizations on track as they change everything from how they buy supplies to how they deliver care.</p><h4>Takeaway</h4><p>“Everyone sees the potential of an integration, but it’s tough to achieve,” says Mark Korth, a partner with Guidehouse. “The end state should expand patient access to improved care, with caregivers and employees feeling a common culture and being part of one organization.”</p><h3><span>2</span> <span>|</span> Inventory everything that the combined organization will need to integrate.</h3><p>A successful integration goes well beyond dollars and square footage. It includes all people and processes — clinical, financial and operational — across both legacy organizations. The combined organization must have a complete inventory to be fully integrated into one entity laser-focused on a shared vision of successful integration.</p><h4>Takeaway</h4><p>Guidehouse sources note that a sample list of people, processes and technology to integrate could include:</p><ul><li><strong>Ancillary clinics.</strong></li><li><strong>Clinical program design.</strong></li><li><strong>Core clinical information technology systems (e.g., electronic health records).</strong></li><li><strong>Core nonclinical IT systems (e.g., enterprise resource planning).</strong></li><li><strong>Independent physicians.</strong></li><li><strong>Physician alignment.</strong></li><li><strong>Human resources.</strong></li><li><strong>Management structure.</strong></li><li><strong>Payer contracting.</strong></li><li><strong>Supply chain.</strong></li><li><strong>Revenue cycle.</strong></li></ul><h3><span>3</span> <span>|</span> Set a realistic yet aggressive timetable for integration.</h3><p>The assembly instructions must include a detailed timeline of how long the integration will take, the important milestones along the way and when the combined organization should complete each milestone. Hospital or health system integrations should take one to two years to complete, according to subject matter experts interviewed for this report. The length of time will vary depending on the breadth of the integration.</p><h4>Takeaway</h4><p>A clear timetable will accomplish several goals. First, it will keep integration momentum going because no one wants to be the leader of the team that falls behind. Second, it will create opportunities to celebrate completions of major milestones. Third, it tells everyone that there is a light at the end of the tunnel and that they’re not on an endless journey. Also, having a shorter time frame makes integration more achievable because it drives everyone’s focus.</p><h3><span>4</span> <span>|</span> Develop a comprehensive integration road map.</h3><p>As in any set of assembly instructions, the secret is doing things in the right order. Partners must take the list of everything the combined organization must integrate and schedule it thoughtfully along the timeline.</p><p>Some processes and technologies must go first to keep the organizations running, including human resources, finance, revenue cycle and supply chain. Others can integrate concurrently, such as payer contracting, management structure and communications. Some must go last because of their inherent subtleties and complexities, e.g., clinical program design and physician alignment.</p><h4>Takeaway</h4><p>“You must have a very clear structure for communications,” says Amy Chieppa, associate director at Guidehouse. “How do I know what’s happening? How do I know who makes the decision? And how do I escalate [issues] when things aren’t going the way I think they should? Your plan must have answers to those questions.”</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } h4 { color: #9d2235; } Tue, 17 Jun 2025 06:15:00 -0500 Mergers & Acquisitions /aha-center-health-innovation-market-scan/2025-06-16-hospital-operators-manual-post-merger-integration <div class="raw-html-embed"> </div><div> /* Banner_Title_Overlay_Bar */ .Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 25px auto; } .Banner_Title_Overlay_Bar h1 { position: absolute; bottom: 40px; color: #003087; background-color: rgba(255, 255, 255, .8); width: 100%; padding: 20px 40px; font-size: 3em; box-shadow: 0 3px 8px -5px rgba(0, 0, 0, .6); } @media (max-width:991px) { .Banner_Title_Overlay_Bar h1 { bottom: 0px; margin: 0px; font-size: 2.5em; } } @media (max-width:767px) { .Banner_Title_Overlay_Bar h1 { font-size: 2em; text-align: center; text-indent: 0px; padding: 10px 20px; } } @media (max-width:530px) { .Banner_Title_Overlay_Bar h1 { position: relative; background-color: #63666A22; } } /* Banner_Title_Overlay_Bar // */ <header class="Banner_Title_Overlay_Bar"><img src="/sites/default/files/2024-01/Trailblazers_Amazon_banner_1170x250.png" alt="Cover of Assembly Required: An Operator’s Manual for Post-merger Integration"><div><h1>A Hospital Operator's Manual for Post-merger Integration</h1></div></header></div> h2{ margin-top: 0px; } p.center_Intro { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 25px 0; font-weight: 700; font-size: 2em; } p.center_Lead { color: #63666A; font-weight: 300; line-height: 1.4; font-size: 21px; } <div class="row"><div class="col-sm-8"><h2>Assembly Required</h2><p>Hospitals and health systems have been merging with each other, acquiring each other and strategically partnering with each other for decades. These deals offer the potential to improve quality, efficiency and more.</p><p>But the post-merger process often can be complex as crafting the merger agreement itself. What’s needed is a detailed plan — an operator’s manual, if you will — to execute the integration of two organizations. Follow this 10-step process to develop an operator’s manual to ensure a successful post-merger transition.</p><div class="row"><div class="col-sm-12"><p><strong>Sponsored by:</strong><a href="https://guidehouse.com/industries/health?utm_source=aha&utm_medium=report&utm_campaign=mergers-acquisitions-playbook&utm_content=aha-trailblazers-report" target="_blank" title="Guidehouse"><strong><img src="/sites/default/files/2020-03/Logo_Guidehouse_834x313.jpg" alt="Guidehouse logo"></strong></a></p></div></div></div><div class="col-sm-4"><h3>TrailBLAZERS</h3><a href="/type/trailblazers" title="View all of AHA's TrailBLAZERS Reports"><img src="/sites/default/files/2024-01/Trailblazers_logo-924x265.png" alt="TrailBlazers" width="100%"></a><p><br><a href="#DownloadNow" title="Download, Assembly Required: An Operator’s Manual for Post-merger Integration"><img src="/sites/default/files/2025-06/Traiblazers_Guidehouse_cover_777x600.png" alt="Cover, Assembly Required: An Operator’s Manual for Post-merger Integration" width="100%"> </a><br><a class="btn btn-primary" href="#DownloadNow" title="Download, Assembly Required: An Operator’s Manual for Post-merger Integration">Download</a></p></div></div> .y-hr3 div:nth-child(2) { border-top: solid 15px #67c1c3; margin: 50px 0px; height: 0px; <div class="row y-hr3"><div class="col-md-3"> </div><div class="col-md-6"> </div><div class="col-md-3"> </div></div><div class="row"><div class="col-sm-4"><img src="/sites/default/files/2025-06/Trailblazers_Guidehouse_FirstSection_700x430.png" alt="xxxxxxxxxxxxxxxxxxxx" width="100%"></div><div class="col-sm-8"><h2>Post-merger Integration Assembly Instructions</h2><p>Building an integrated hospital or health system after a merger can be complicated because hospitals and health systems are some of the most complicated and sophisticated organizations. Yet the general steps taken to successfully integrate hospitals and health systems are strikingly similar to the steps and concepts required to build a shelving unit, for example.</p><p><a href="#DownloadNow" title="Download, Assembly Required: An Operator’s Manual for Post-merger Integration"><strong>READ MORE.</strong></a></p></div></div><div class="row y-hr3"><div class="col-md-3"> </div><div class="col-md-6"> </div><div class="col-md-3"> </div></div><div class="row"><div class="col-sm-4"><img src="/sites/default/files/2025-06/Trailblazers_Guidehouse_HenryFord_Health_700x532.png" alt="Exterior of Henry Ford Health"></div><div class="col-sm-8"><h2>Case Study: Henry Ford Health and Ascension Michigan</h2><h3>Putting a Premium on Change Management and Cultural Integration</h3><p>In October 2023, Henry Ford Health and Ascension Michigan agreed to transfer majority ownership of eight Ascension Michigan hospitals to Henry Ford Health through a joint venture. The parties completed the deal in fall 2024, making Henry Ford Health a 13-hospital system. Key to the successful integration of the two organizations has been the creation of a physician advisory council and a cultural integration team to ensure that physicians and valued team members closest to the care team are on the same page from both change-management and cultural-integration perspectives.</p><p><a href="#DownloadNow" title="Download, Assembly Required: An Operator’s Manual for Post-merger Integration"><strong>READ MORE.</strong></a></p></div></div><div class="row y-hr3"><div class="col-md-3"> </div><div class="col-md-6"> </div><div class="col-md-3"> </div></div><div class="row"><div class="col-sm-4"><img src="/sites/default/files/2025-06/Trailblazers_Guidehouse_USA_Health_700x532.png" alt="Exterior of USA Health"></div><div class="col-sm-8"><h2>Case Study: USA Health</h2><h3>Operating Model First, Technology Second</h3><p>In April 2023, USA Health acquired Providence Hospital. The transaction brought the hospital and 14 clinics into USA Health, which operates University Hospital and Children’s and Women’s Hospital, and the Mitchell Cancer Institute. The integration focused on developing a common mission, vision and culture. In their post-integration operating model, the two organizations determined that tech infrastructure along with the details of how the two organizations would combine into one should support the operating model.</p><p><a href="#DownloadNow" title="Download, Assembly Required: An Operator’s Manual for Post-merger Integration"><strong>READ MORE.</strong></a></p></div></div><div> .SponsorMarketoForm { background-color: ; padding:5px 25px; border: solid 2px #307FE2; margin:50px 15px 0px !important; display:inline-block; width:100%; } .SponsorMarketoForm h3{ margin:10x 0 0 0 ; color:#eaaa00; font-size:.7em; text-transform:uppercase; font-weight:400; letter-spacing:3px; max-width:200px; /* Custom for the copy length */ background-color:#fff; padding: 5px 15px; position:relative; top:-35px; height: 0px; } .SponsorMarketoForm h2{ color: #002855; } .SponsorMarketoForm .SponsorMarketoFormHolder{ background-color: ; padding:15px; display: inline-block; margin-bottom:25px; } .SponsorMarketoFormHolder form{ margin: auto; 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} <div class="row spacer" id="DownloadNow"><div><div class="col-md-1"> </div><div class="col-md-10"><div class="cta--image-container full_width SponsorMarketoForm"><h3>Download Now</h3><div class="col-md-9"><h2>Assembly Required</h2><div class="SponsorMarketoFormHolder">   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 4718); MktoForms2.whenReady(function(form) { if (form.getId() == 4718) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML = "<div><p>Thank you for downloading the latest AHA Trailblazers.<\/p><a class='btn btn-wide btn-primary' data-view-context='top-level-view' href='https:\/\/www.aha.org\/system\/files\/media\/file\/2025\/06\/Trailblazers_Guidehouse_Mergers.pdf' target='_blank' rel='noopener noreferrer nofollow'>Download the Report<\/a><\/center><\/div>"; return false; }); }; }); <div id="successAndErrorMessages"> </div></div></div><div class="col-md-3"><img src="/sites/default/files/2025-06/Traiblazers_Guidehouse_cover_777x600.png" alt="Cover of Assembly Required: An Operator’s Manual for Post-merger Integration"></div></div></div><div class="col-md-1"> </div></div></div></div> Mon, 16 Jun 2025 12:00:00 -0500 Mergers & Acquisitions /news/headline/2025-03-31-doj-launches-anticompetitive-regulations-task-force <p>The Department of Justice March 27 <a href="https://www.justice.gov/opa/pr/justice-department-launches-anticompetitive-regulations-task-force">announced</a> it is launching an Anticompetitive Regulations Task Force to advocate for “the elimination of anticompetitive state and federal laws and regulations that undermine free market competition.” The DOJ said its Antitrust Division is seeking <a href="https://www.regulations.gov/">public comments</a> until May 26 on laws and regulations considered to be the most significant barriers to competition in markets such as health care, housing, transportation, food and agriculture, and energy. </p> Mon, 31 Mar 2025 16:01:51 -0500 Mergers & Acquisitions /lettercomment/2025-02-12-aha-other-organizations-support-congressional-review-act <p>February 12, 2025</p><table><tbody><tr><td>The Honorable Jim Jordan<br>Chair<br>Committee on the Judiciary<br>U.S. House of Representatives<br>Washington, D.C. 20515</td><td>The Honorable Scott Fitzgerald <br>Chair<br>Subcommittee on the Administrative State, <br>Regulatory Reform, and Antitrust<br>U.S. House of Representatives Washington, D.C. 20515</td></tr><tr><td>The Honorable Jamie Raskin <br>Ranking Member, Committee on the Judiciary<br>United States House of Representatives<br>Washington, D.C. 20515<br> </td><td>The Honorable Jerrold Nadler<br>Ranking Member, Subcommittee on the <br>Administrative State, Regulatory Reform, and Antitrust<br>United States House of Representatives <br>Washington, D.C. 20515</td></tr></tbody></table><p>Dear Chairman Jordan, Subcommittee Chair Fitzgerald, Ranking Member Raskin, and Ranking Member Nadler:</p><p>The undersigned organizations write to express our support for the use of the Congressional Review Act (CRA) to overturn the Federal Trade Commission's (FTC) recent premerger notification rules ("Rules"). The Rules have also been challenged in court for violating the Administrative Procedures Act as being unnecessary and overly burdensome. Overturning the Rule would efficiently allow the FTC to restart the rulemaking process and promulgate rules that are less burdensome and more narrowly targeted.</p><p>As a general matter, mergers and acquisitions (M&A) often promote efficiency and competition by allowing companies of all sizes to put assets to their highest and best use. M&A activity can also spur innovation: smaller companies, entrepreneurs, and early-stage investors benefit from opportunities for capital formation, liquidity, and growth, as well as the possibility of a future exit.  Larger businesses utilize M&A to unlock efficiencies, enhance research and development, and expand operations.</p><p>When Congress passed the Hart-Scott-Rodino Act ("HSR Act") it explicitly wanted to avoid "deter[ring] ... the vast majority of mergers and acquisitions." Congress recognized that M&A activity usually improves competition by "generat[ing] significant efficiencies and thus enhanc[ing] the merged firm's ability and incentive to compete, which may result in lower prices, improved quality, enhanced service, or new products."<sup>1 </sup>Thus, the Rules should be geared toward identifying the small percentage of mergers that may harm competition and avoid unduly burdening the vast majority of mergers that either help competition or are neutral.</p><p>To accomplish this, the HSR Act establishes a two-stage process. An initial filing stage that applies to all HSR mergers above a certain size and provides the agencies high-level information about the transaction, and a "second request" stage that grants the FTC and the Department of Justice enormous power to request additional information for any merger that they wish to further scrutinize.<sup>2</sup> More recently, the Consolidated Appropriations Act of 2023, directed the FTC to revise the form used for merger notifications for one specific purpose: to solicit data on foreign subsidies originating from countries of concern.</p><p>But rather than simply updating the form as Congress directed, the FTC proposed sweeping changes. The Republican FTC commissioners, who were powerless to stop the rule, were successful in paring back the final Rule in exchange for their support, but both Republican Commissioners made clear in their statements that this was not a rule they would have written.<sup>3</sup></p><p>According to the government's own data, 98% of mergers do not raise competitive concerns. But the new Rule assumes that almost all M&A activity is inherently problematic, and subjects businesses from small to large - and reportable transactions from simple to complex - to what is effectively the burdensome "second request" process normally reserved for M&A activity that the FTC or DOJ have determined could violate the antitrust laws.</p><p>The increased burden the final Rule imposes is unjustifiable: increased bureaucracy that has the effect of deterring mergers will stifle innovation, reduce market efficiencies, and ultimately harm consumers who benefit from the competitive dynamics that mergers can and do foster.4 Further, the agencies do not have the resources to make use of the additional information the Rule would demand from all merger filings. Informational overload will force the agencies to divert resources away from the handful of mergers that require closer scrutiny. Moreover, having digested the final Rule's 460 pages, merger filing experts agree that it provides little benefit for the overwhelming number of reportable transactions, fails to consider less burdensome alternatives, and affords the government too much discretion to reject filings based on political criteria.</p><p>Moreover, the FTC made changes that are in direct violation of administrative law. For example:</p><ul><li>At no time during the rulemaking process did the FTC present any justification to support its finalized changes. The FTC cannot point to a single merger that was not thoroughly reviewed because information at the initial filing stage was lacking.</li><li>The FTC dramatically underestimates the costs of and cannot identify benefits associated with the additional burden imposed on every merger filing. This is a significant burden because roughly 98% of mergers do not currently undergo a "second request."</li><li>The FTC failed to appropriately consider alternatives that might keep the existing form for the vast majority of mergers, and subject only a subset of transactions to a reasonable additional initial filing burden.</li><li>The Rule was significantly changed from the proposed rule that was available for public comment. Administrative law requires that the FTC restart the rulemaking process and seek additional comment, given the dramatic changes made between the proposed and final Rule.</li><li>Because the public has not had an opportunity to comment on the Rule, the Rule's publication also runs afoul of the Administrative Procedure Act, the Paperwork Reduction Act, Regulatory Flexibility Act, and Small Business Regulatory Enforcement Fairness Act.</li></ul><p>To be clear, the business community has no objections to the Congressionally mandated changes to the HSR form related to the collection of information about foreign subsidies. Nor does the business community object to reasonable updates to the form beyond what Congress recently directed. However, additional changes must be justifiable and targeted to identify anticompetitive mergers, not to add sweeping and unnecessary requirements.</p><p>A Congressional repeal of this Rule would allow the FTC to issue a new NPRM consistent with Congress's two-tier approach to merger review. With a new NPRM, the FTC could gather public comments on the Rule's costs and benefits, as well as options for less burdensome alternatives.</p><p>Invoking Congress's prerogative as provided in the CRA will help clear the way toward re-establishing a predictable, efficient process for agency review of M&A activity. Repeal also would save taxpayer money by mooting the legal challenges brought against the FTC by concerned plaintiffs. We therefore urge Congress to enact a resolution of disapproval to vitiate the FTC's Rule.</p><p>Sincerely,</p><p>ACT I The App Association<br>AdvaMed<br>Alternative Investment Management Association<br>American Investment Council<br>American Coatings Association<br>���������� Association <br>Business Roundtable<br>Biotechnology Innovation Organization (BIO)<br>Center for American Entrepreneurship<br>Computer & Communications Industry Association (CCIA)<br>Connected Commerce Council<br>Connected Health Initiative<br>Consumer Technology Association<br>Energy Equipment & Infrastructure Alliance <br>Engine<br>Federation of ����������s<br>Global Business Alliance<br>Information Technology Industry Council (ITI)<br>International Franchise Association<br>Managed Funds Association<br>Metals Service Center Institute<br>National Association of Manufacturers<br>National Industrial Transportation League<br>National Parking Association<br>National Pest Management Association<br>National Retail Federation<br>National Venture Capital Association (NVCA)<br>NetChoice<br>Partnership for the U.S. Life Science Ecosystem (PULSE)<br>Pharmaceutical Research and Manufacturers of America (PhRMA)<br>Retail Industry Leaders Association <br>Silicon Valley Leadership Group<br>Small Business & Entrepreneurship Council<br>Software Information Industry Association (SIIA)<br>TechNet<br>United States Hispanic Business Council<br>U.S. Chamber of Commerce<br>Western States Trucking Association</p><p>CC: Members of the House Judiciary Committee</p><p>__________ <br><small class="sm"><sup>1 </sup>S. Rep. No. 94-803, at 66 (emphasis added)</small><br><small class="sm"><sup>2</sup> The agencies also frequently use voluntary access letter to gather additional information from the merging parties before issuing a second request.</small><br><small class="sm"><sup>3</sup> See. Concurring Statement of Commissioner Andrew N. Ferguson in the Matter of Amendments to the Premerger Notification and Report Form and Instructions, and the Hart-Scott-Rodino Rule 16 C.F.R. Parts 801 and 803, U.S. Federal Trade Comm., October 10, 2024, at 5, "[t]he Final Rule is not perfect, nor is it the rule I would have written if the decision were mine alone." See a/so. Statement of Commissioner Melissa Holyoak Regarding Final Premerger Notification Form and the Hart-Scott-Rodino Rules. Federal Trade Comm., October 10, 2024, at 1, "[t]o be clear, this Final Rule does not align exactly with my preferences."</small><br><small class="sm"><sup>4</sup> Evidence of Efficiencies in Consummated Mergers, Maureen K. Ohlhausen & Taylor M. Owings (June 2023), available at </small><a class="ck-anchor" href="https://www.uschamber.com/assets/documents/20230601-Merger-Efficiencies-White-Paper.pdf" id="https://www.uschamber.com/assets/documents/20230601-Merger-Efficiencies-White-Paper.pdf"><small class="sm">https://www.uschamber.com/assets/documents/20230601-Merger-Efficiencies-White-Paper.pdf</small></a><small class="sm">  (A survey of research on consummated mergers demonstrates mergers "can and do advance procompetitive business objectives.")</small><br> </p> Wed, 12 Feb 2025 14:13:56 -0600 Mergers & Acquisitions /news/headline/2025-01-16-report-hospitals-and-health-systems-stabilized-2024-continue-face-distress <p>A <a href="https://www.kaufmanhall.com/insights/research-report/hospital-and-health-system-ma-review-despite-industry-stabilization" title="research report">report</a> released Jan. 9 by Kaufman Hall highlights hospital and health system merger and acquisition activity from last year. <br> </p><p>The report said that announced transactions involving a financially distressed party hit a record high 30.6%. It also found that 62.5% of the announced transactions involved a divestiture, the highest percentage the industry has experienced and more than double the percentage from 2023. The percentage of announced transactions in which the smaller party had a credit rating of A- or higher dropped to an all-time low of 2.8%. </p> Thu, 16 Jan 2025 15:26:31 -0600 Mergers & Acquisitions /news/headline/2025-01-13-chamber-commerce-files-lawsuit-against-ftc-changes-premerger-notification-rules <p>The U.S. Chamber of Commerce Jan. 13 filed a <a href="https://www.uschamber.com/assets/documents/Complaint-Chamber-of-Commerce-v.-FTC-E.D.-Tex.pdf">lawsuit</a> against the Federal Trade Commission, saying changes made by the FTC to premerger notification rules under the Hart-Scott-Rodino Act are “unnecessary and unlawful.”</p><p>In a statement, the Chamber said the FTC “has failed to justify the need to subject every merger filing to its new burden. During the rulemaking process it never contemplated alternative, less burdensome approaches and understates the costs and overstates the benefits of changing the rule as part of its final analysis. Subjecting thousands of routine mergers and acquisitions to these additional burdens will slow down normal business transactions and increase costs, hurting the economy in the process.”</p><p>The FTC finalized changes to the premerger notification rules, form and instructions under the HSR Act in October. The AHA expressed disappointment with the FTC's changes, <a href="/news/headline/2024-10-11-ftc-issues-ruling-premerger-notification-rules-increases-burden-merging-organizations">saying</a> that the rule “functions as little more than a tax on mergers... The agency already has more than enough information about hospital transactions, and it has shown no hesitation in challenging them. The final rule will just require hospitals to divert time and resources away from patient care towards needless compliance costs.”</p> Mon, 13 Jan 2025 17:02:45 -0600 Mergers & Acquisitions /news/headline/2024-10-11-ftc-issues-ruling-premerger-notification-rules-increases-burden-merging-organizations <p>The Federal Trade Commission Oct. 10 finalized <a href="https://www.ftc.gov/legal-library/browse/federal-register-notices/final-rule-premerger-notification-reporting-waiting-requirements" target="_blank" title="Federal Trade Commission: Final Rule: Premerger Notification; Reporting and Waiting Requirements">changes to the premerger notification rules</a>, form and instructions under the Hart-Scott-Rodino Antitrust Improvements Act. The final rule, while less burdensome than the proposed rule, increases the reporting requirements on the current HSR form, particularly for the buyer.</p><p>“The AHA is disappointed that the FTC moved forward with this flawed and pointless rule,” stated Chad Golder, AHA general counsel and secretary. “As we explained in our comment letter, it functions as little more than a tax on mergers. The FTC still has not sufficiently explained why all this information is needed. The agency already has more than enough information about hospital transactions, and it has shown no hesitation in challenging them. The final rule will just require hospitals to divert time and resources away from patient care towards needless compliance costs.” When the FTC issued the proposal in 2023, the <a href="/lettercomment/2023-09-05-aha-urges-ftc-withdraw-proposed-changes-premerger-notification-rules">AHA urged the FTC to withdraw its proposed changes</a>, stating it would add unnecessary burdens and increase costs without adding benefits. The final rule and HSR form will go into effect 90 days after publication in the federal register.</p> Fri, 11 Oct 2024 13:04:24 -0500 Mergers & Acquisitions /testimony/2024-05-23-aha-statement-house-budget-committee-value-hospital-systems <p class="text-align-center"><strong>Statement</strong><br><strong>of the</strong><br><strong>���������� Association</strong><br><strong>for the</strong><br><strong>Committee on the Budget</strong><br><strong>of the</strong><br><strong>U.S. House of Representatives</strong></p><p class="text-align-center"><strong>“Breaking Up Health Care Monopolies: Examining the Budgetary Effects of Health Care Consolidation”</strong></p><p class="text-align-center"><strong>May 23, 2024</strong></p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) writes to share the hospital perspective on the ways hospital mergers and acquisitions can expand and preserve access to quality care.</p><h2>MERGERS AND ACQUISITIONS HELP HOSPITALS MANAGE ONGOING FINANCIAL PRESSURES</h2><p>Hospitals and health systems continue to experience significant financial pressures that challenge their ability to provide 24/7 care for the patients and communities they serve. Mergers and acquisitions allow some hospitals use to manage these pressures and increase access to care for patients.</p><p>A <a href="/system/files/media/file/2024/05/Americas-Hospitals-and-Health-Systems-Continue-to-Face-Escalating-Operational-Costs-and-Economic-Pressures.pdf">recent report</a> released by the AHA details the extraordinary financial pressures continuing to affect access to patient care. In 2023, hospitals and health systems again sustained substantial expenses due to high costs for labor, drugs and supplies, ongoing workforce challenges and growing administrative burdens. At the same time, hospitals and health systems increasingly encounter the twin challenges of navigating onerous commercial insurer practices that deny and delay payment for care provided to patients, while reimbursements from Medicare and Medicaid have failed to keep pace with mounting costs.</p><p>Merging with a hospital system can help some hospitals ease these financial burdens and improve patient care. Among other benefits, mergers are a tool that expand access to care for patients and allow hospitals to achieve the scale and increase the efficiency in purchasing medical services, supplies and prescription drugs. Mergers also help to reduce other operational costs through shared service models for departments like information technology (IT), human resources, finance and compliance. Hospitals and health systems should be permitted to pursue the type of arrangements that work best for their patients and community, including independent status, mergers or other partnerships.</p><h2>BENEFITS OF HOSPITAL MERGERS AND ACQUISITIONS TO PATIENTS AND COMMUNITIES</h2><p>Hospital mergers and acquisitions bring measurable benefits to patients and communities, including increased access to care, improved quality and lower health care costs.</p><h3>Better Access to Care</h3><p>Mergers and acquisitions also play a critical role in preserving access to care, especially for patients and hospitals in rural or other underserved communities. In particular, they help hospitals improve access to care by expanding the types of specialists and services available to patients. According to an analysis by the health care consulting firm Kaufman Hall, nearly 40% of affiliated hospitals added one or more services post-acquisition. Almost half of all hospitals acquired by an academic medical center added one or more service. Patients at hospitals acquired by academic medical centers or large health systems also gained improved access to tertiary and quaternary services.<sup>1</sup></p><p>Mergers and acquisitions also are a vital tool that some health systems use to keep financially struggling hospitals open and serving their communities, thereby averting bankruptcy or even closure. When hospitals become part of a health system, the acquired hospital can more easily and cohesively access services and specialties available at other hospitals within the system. As a result, the continuum of care is strengthened for patients and the community, resulting in better care, increased access to specialty care and decreased readmission rates overall.</p><p>This is particularly true in rural and underserved communities. Health systems typically acquire hospitals in these communities when the hospitals are under financial distress.  The results are demonstrable. Research has shown that rural hospitals are less likely to close after acquisition compared to independent hospitals and that mergers have improved access and quality of care for rural hospitals.<sup>2</sup></p><h3>Improved Quality</h3><p>Emerging research has demonstrated a clear association between consolidation and quality improvement, indicating that hospital mergers and acquisitions may lead to better quality of care. For example, one study found that a full-integration approach is associated with improvements in mortality and readmission rates, among other quality and outcome improvements.<sup>3</sup> This is due to quality improvement in part due to the integration of information technology and analytic-driven interventions, both made possible by leveraging the health systems resources in the acquired hospital. Another study found significant reductions in mortality for a number of common conditions — including acute myocardial infarction, heart failure, acute stroke and pneumonia — among patients at rural hospitals that had merged or been acquired.<sup>4</sup></p><h3>Lower Health Care Costs</h3><p>Mergers and acquisitions help reduce health care costs and are an effective tool for hospitals to operate more efficiently and cope with escalating costs. For example, a Charles River Associates analysis for the AHA shows that hospital acquisitions are associated with a statistically significant 3.3% reduction in annual operating expenses per admission at acquired hospitals, along with a 3.7% decrease in net patient revenue per adjusted admission.<sup>5</sup></p><p>The same report shows that additional benefit come from improved IT systems and advanced data analytics. Merged hospitals can often better invest in IT infrastructure for both clinical and financial data that can be used to identify best practices for more cost-effective, integrated and streamlined care. These data systems have substantial, but largely, fixed costs, making them effectively inaccessible to independent hospitals but scalable for larger systems.</p><h5>INSURERS LEVERAGE THEIR MARKET POWER AT THE EXPENSE OF HOSPITALS AND HEALTH SYSTEMS</h5><p>Hospitals and health systems face significant pressure from health insurance companies, which are leveraging their market power in a way that drives up hospital and health system costs. For example, in nearly half of all markets, a single health insurer controls at least 50% of the commercial market.<sup>6</sup> Commercial health insurers can — and do — use this market power to increase health insurance premiums as research has found that marketplace insurance premiums grow faster in areas with less insurer competition.<sup>7</sup> Commercial insurers also have used their market power to implement policies that compromise patient safety and raise costs for hospitals and patients alike, such as prior authorization delays, denying coverage for medically necessary care, or forcing patients to try potentially ineffective treatments or therapies.<sup>8</sup></p><p>Due to burnout associated with commercial insurer policies like prior authorization and low reimbursement rates, most physicians are choosing to become employed rather than operate their own practices. While a disproportionate amount of attention has been placed on hospitals’ acquisition of physician practices, large commercial insurers including CVS Health and UnitedHealth Group have recently spent billions of dollars acquiring practices. In fact, non-hospital entities including health insurers have acquired 90% of physician practices over the last five years. <sup>9</sup> We urge this committee to examine the costs and impact on health care access and affordability associated with this widespread acquisition of America’s physicians by corporate health insurance companies.</p><p>We are concerned that the scope of major commercial insurers increases costs in the heath care system. Studies have shown that highly concentrated insurer markets are associated with higher premiums and that insurers are not likely to pass on to consumers any savings achieved through lower provider rates.<sup>10 </sup>We urge Congress to examine these issues and their impact on health care delivery for patients across the country.</p><h5>MISGUIDED LEGISLATIVE PROPOSALS WILL REDUCE ACCESS TO CARE</h5><p>We are concerned that certain legislative proposals that claim to increase competition in health care — including those that would create additional Medicare site-neutral payment cuts and ease growth restrictions on physician-owned hospitals — would jeopardize access to care for patients.</p><h3>Site-neutral Payment Reductions</h3><p>The AHA strongly opposes efforts to expand site-neutral payment cuts. Current Medicare payment rates appropriately recognize that there are fundamental differences between patient care delivered in hospital outpatient departments (HOPDs) compared to other settings. HOPDs provide important access to care for Medicare beneficiaries, many of which are more likely to be sicker and more medically complex than those treated at physicians’ offices, while also being held to stricter safety and regulatory requirements.</p><p>The cost of care delivered in hospitals and health systems considers the unique benefits they provide to their communities, which are not provided by other sites of care. This includes investments made to maintain standby capacity for natural and manmade disasters, public health emergencies and unexpected traumatic events, as well as delivering 24/7 emergency care to all who come to the hospital.</p><p>Existing site-neutral payment cuts have already created significant financial challenges for many hospitals and health systems. This is largely because Medicare underpays hospitals for the cost of caring for patients. The latest <a href="/2024-01-10-infographic-medicare-significantly-underpays-hospitals-cost-patient-care">analysis</a> shows that on average Medicare pays only 82 cents for every dollar of hospital care provided to Medicare beneficiaries, leaving hospitals with nearly $100 billion in Medicare shortfalls in 2022 alone. As a result, two-thirds of all hospitals reported negative Medicare margins in 2022. Any additional site-neutral cuts would exacerbate these financial challenges and further reduce access to essential care and services in communities.</p><h3>Physician-owned Hospitals</h3><p>America’s community hospitals and health systems welcome fair competition, where health care entities can compete based on quality, price, safety and patient satisfaction. But physician-owned hospitals (POH) — where physicians select the healthiest and best-insured patients and self-refer those patients to facilities in which they have an ownership interest — represent the antithesis of competition.</p><p>POHs provide limited emergency services, are ill-equipped to respond to public health crises, and they increase costs for patients, other providers, and the federal government. The <a href="https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/costestimate/amendreconprop.pdf" target="_blank">Congressional Budget Office</a>, the <a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/Mar05_SpecHospitals.pdf" target="_blank">Medicare Payment Advisory Commission</a> and the <a href="https://public-inspection.federalregister.gov/2023-16252.pdf" target="_blank">Centers for Medicare & Medicaid Services</a> all have concluded that physician self-referral leads to greater per capita utilization of services and higher costs for the Medicare program, among other negative impacts.</p><p>The AHA strongly opposes any changes to current law that would either expand the number of POHs or ease restrictions on the growth of existing facilities. Allowing more POHs in rural areas could be particularly destabilizing because these areas already have a limited patient population, with hospitals struggling to maintain fixed-operating costs.</p><h2>GREATER COMMERCIAL INSURER ACCOUNTABILITY IS NEEDED</h2><p>We urge Congress to address harmful practices from commercial insurers like prior authorization that lead to delays in patient care and increase costs and burdens to hospitals and health systems. Inappropriate denials for prior authorization and coverage of medically necessary services are a pervasive problem among certain plans in the Medicare Advantage program. This results in delays in care, wasteful and potentially dangerous utilization of fail-first requirements for imaging and therapies, and other direct patient harms. These practices also add financial burden and strain to the health care system through inappropriate payment denials and increased costs to comply with plan requirements.</p><p>The AHA supports regulations and legislative solutions that streamline and improve prior authorization processes, including the Improving Seniors’ Timely Access to Care Act, which would codify many of the reforms in the Interoperability and Prior Authorization final rule.</p><h2>CONCLUSION</h2><p>The AHA appreciates your efforts to examine this issue and looks forward to continuing to work with you.</p><p>__________</p><p><sup>1</sup> <a href="/system/files/media/file/2021/10/KH-AHA-Benefits-of-Hospital-Mergers-Acquisitions-2021-10-08.pdf">/system/files/media/file/2021/10/KH-AHA-Benefits-of-Hospital-Mergers-Acquisitions-2021-10-08.pdf</a> <br><sup>2</sup> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250050/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250050/</a> </p><p><sup>3</sup><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787652">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787652</a></p><p><sup>4</sup><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784342">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784342</a></p><p><sup>5</sup><a href="/guidesreports/2021-08-18-hospital-merger-benefits-econometric-analysis-revisited-executive-summary">/guidesreports/2021-08-18-hospital-merger-benefits-econometric-analysis-revisited-executive-summary</a></p><p><sup>6</sup><a href="https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-care-research">https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-care-research</a> </p><p><sup>7</sup> <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0054">https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0054</a></p><p><sup>8</sup><a href="/white-papers/2022-07-28-commercial-health-plans-policies-compromise-patient-safety-and-raise-costs">/white-papers/2022-07-28-commercial-health-plans-policies-compromise-patient-safety-and-raise-costs</a></p><p><sup>9</sup><a href="/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf">/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf</a> </p><p><sup>10</sup><a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.0548">https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.0548</a> <br> </p> Thu, 23 May 2024 08:30:54 -0500 Mergers & Acquisitions /2024-05-22-aha-statement-house-ways-and-means-subcommittee-physician-practice-consolidation <p class="text-align-center"><strong>Statement</strong><br><strong>of the</strong><br><strong>���������� Association</strong><br><strong>for the</strong><br><strong>Committee on Ways and Means</strong><br><strong>Subcommittee on Health</strong><br><strong>of the</strong><br><strong>U.S. House of Representatives</strong></p><p class="text-align-center"><strong>“The Collapse of Private Practice: Examining the Challenges Facing Independent Medicine”</strong></p><p class="text-align-center"><strong>May 23, 2024</strong></p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) appreciates the opportunity to provide our perspective on the financial and regulatory burdens facing physician practices.</p><h2>FACTORS DRIVING PHYSICIAN PRACTICE ACQUISITIONS</h2><p>Much like hospitals and health systems, physicians across the country are facing increased costs, inadequate reimbursements and administrative burdens from public and private insurer practices. These factors create major barriers to operating an independent physician practice. As a result, physicians are increasingly looking for alternative practice settings that will provide financial security so they can focus more on clinical care and less on managing their own practice. Hospitals and health systems are an appropriate partner to help physicians alleviate many of these burdens.</p><h3>Commercial Insurer Policies and Practices</h3><p>Onerous policies from commercial health insurers have spurred many physicians to seek employment instead of maintaining their own practices. According to a recent survey of physicians conducted by Morning Consult on behalf of the AHA, 84% of employed physicians reported that administrative burden from payers — including prior authorization and reporting requirements — has adversely impacted their ability to operate an independent practice.<sup>1</sup> In the same survey, 81% of physicians reported that commercial insurer policies and practices interfered with their ability to practice medicine.<sup>2</sup></p><p>Excessive prior authorization requirements and inappropriate denials of coverage for medically necessary services are a pervasive problem among certain plans in the Medicare Advantage (MA) program. These insurer practices result in delays in care and add financial burden and strain to the health care system, including increased staffing and technology costs to comply with plan requirements. Additionally, the administrative burden of prior authorization requirements and processes further strain the health care workforce and contribute to provider burnout. In fact, Surgeon General Vivek Murthy, M.D., issued a recent advisory that notes that burdensome documentation requirements, including the volume of and requirements for prior authorization, are drivers of health care worker burnout.<sup>3</sup></p><h3>Escalating Costs</h3><p>Managing a physician practice often includes significant operational costs associated with maintaining electronic health records and patient portals, processing billing and claims submissions, including managing prior authorization requirements, and office rent, among other expenses. The costs associated with these requirements range from $20 for a primary care office visit to as high as $215 for a procedure at an inpatient surgical center.<sup>4</sup></p><p>Compounding that problem, low reimbursement rates from public payers like Medicare and Medicaid are another barrier to the practice of medicine in a private practice setting. Reimbursement updates have failed to account for rising inflation and increasing input costs like supply chain disruptions and workforce shortages. Appropriately accounting for these trends is essential to ensure that Medicare payments for professional services more accurately reflect the cost of providing care. Medicare physician payment was effectively cut 26%, adjusted for inflation, from 2001 to 2023.<sup>5</sup> The widening gap between inflation and physician reimbursement rates poses significant threats to patient access and provider financial stability, particularly for safety net providers. </p><p>As a result of these factors, 94% of physicians believe it has become more financially and administratively difficult to operate a practice in recent years.<sup>6</sup></p><h2>SETTING THE RECORD STRAIGHT ABOUT PHYSICIAN ACQUISITIONS</h2><p>While a disproportionate amount of attention has been placed on hospitals’ acquisition of physician practices, the reality is that large commercial insurers including CVS Health and UnitedHealth Group have recently spent billions of dollars to acquire physician practices. In fact, non-hospital entities including health insurers have acquired 90% of physician practices over the last five years.<sup>7</sup></p><p>UnitedHealth Group is now the single largest employer of physicians in the country with over 10% of physicians in the U.S. employed or affiliated. We urge this committee to examine the costs and impact on health care access and affordability associated with this widespread acquisition of America’s physicians by corporate health insurance companies.</p><h3>Hospitals and Health Systems Preserve Access to Care</h3><p>Hospitals have offered a lifeline to physician practices struggling to keep their doors open, especially in rural areas. The challenging economics of providing care in rural communities contribute to gaps in access. Rural communities, by nature, generally have fewer people and therefore do not generate the health care utilization to finance the full range of health care services. In addition, caring for rural patients can be more costly on a per patient basis as patients in rural communities tend to have more complex health care needs, are much more likely to be uninsured, and are more likely to rely on public programs when they do have coverage. As such, many providers have struggled to stay open and provide care to their patients and community.</p><p>Hospitals have stepped in to support these access points for rural patients. Despite the fact that hospital have only acquired 6% of all physician practices in the last five years, hospitals were 2.5 times more likely than other entities to acquire practices in rural areas<sup>.8</sup> Commercial insurers in particular are overwhelmingly focused on larger, more profitable markets where the financial upside is greater. Median household income was on average 18.4% higher in counties where insurers acquired physician practices compared to counties where hospitals acquired physician groups.<sup>9</sup> Additionally, the county level population where commercial insurers acquired physician practices was on average 61.4% larger than it was for hospitals.</p><h2>POLICY RECOMMENDATIONS</h2><p>The AHA supports the following policies to address the burdens and costs associated with operating independent physician practices.</p><p><strong>Commercial Insurer Accountability.</strong> Reduce administrative burdens like prior authorization that contribute to provider burnout and delay access to care.</p><ul><li>The AHA supports regulations and legislative solutions that streamline and improve prior authorization processes, including the Improving Seniors’ Timely Access to Care Act, which would codify many of the reforms in the Interoperability and Prior Authorization Final Rule.</li><li>Gold-carding programs substantially reduce administrative burdens and costs by streamlining access to care for Medicare beneficiaries. The AHA supports the GOLD Card Act of 2023 (H.R. 4968), which would exempt providers from requiring prior authorization for a MA plan year if the provider had at least 90% of prior authorization requests approved the preceding year.</li></ul><p><strong>Physician Payment Reform. </strong>Current reimbursement for physicians is woefully inadequate and fails to account for inflation. The AHA supports legislative and regulatory changes to ensure more sustainable physician reimbursement and to facilitate transition to value-based care.</p><ul><li>The current conversion factor updates scheduled in MACRA are insufficient since they are scheduled to begin in 2026 and will only result in a .75% conversion factor update for qualifying advanced Alternative Payment Model (APM) participants and .25% for all other providers. This will exacerbate the widening gap between inflation and physician reimbursement rates. While the one-time conversion factor updates provided in the Consolidated Appropriations Acts of 2022, 2023 and 2024 have provided needed relief in the interim, we encourage more sustainable, real-time approaches to updating the conversion factors in pace with inflation. Annual conversion factor updates should be made to reflect changes in input costs and inflation outside of budget neutrality.</li><li>To support the transition to value-based payment, the AHA urges Congress to extend APM incentive payments and for CMS to remove problematic high/low revenue thresholds that preclude rural and critical access hospitals from obtaining necessary resources for infrastructure investment. We support the Value in Health Care Act (H.R. 5013/S. 3503), which would extend incentive payments, remove revenue distinctions and improve financial benchmarks to ensure participants are not penalized for their own success.</li></ul><p><strong>Provider Well-being.</strong> We urge Congress to continue to address health care worker well-being by supporting the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153/S. 3679), which would provide grants to help health care organizations offer behavioral health services to prevent burnout and suicide for health care workers through 2029.</p><h2>CONCLUSION</h2><p>The AHA appreciates your efforts to examine the increased burdens and costs facing physician practices and looks forward to working with you to address these issues.</p><p>__________</p><p><small class="sm"><sup>1</sup> </small><a href="/system/files/media/file/2023/07/The-Majority-of-Nurses-and-Physicians-Say-That-Health-Insurer.pdf"><small class="sm">/system/files/media/file/2023/07/The-Majority-of-Nurses-and-Physicians-Say-That-Health-Insurer.pdf</small></a></p><p><small class="sm"><sup>2</sup> </small><a href="/fact-sheets/2023-06-07-fact-sheet-examining-real-factors-driving-physician-practice-acquisition"><small class="sm">/fact-sheets/2023-06-07-fact-sheet-examining-real-factors-driving-physician-practice-acquisition</small></a></p><p><small class="sm"><sup>3</sup>  </small><a href="https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf"><small class="sm">https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf</small></a></p><p><small class="sm"><sup>4</sup> </small><a href="https://jamanetwork.com/journals/jama/fullarticle/2673148"><small class="sm">https://jamanetwork.com/journals/jama/fullarticle/2673148</small></a></p><p><small class="sm"><sup>5</sup> </small><a class="ck-anchor" href="https://www.ama-assn.org/practice-management/medicare-medicaid/advocacy-action-leading-charge-reform-medicare-pay" id="https://www.ama-assn.org/practice-management/medicare-medicaid/advocacy-action-leading-charge-reform-medicare-pay"><small class="sm">https://www.ama-assn.org/practice-management/medicare-medicaid/advocacy-action-leading-charge-reform-medicare-pay</small></a></p><p><small class="sm"><sup>6 </sup></small><a href="/system/files/media/file/2023/07/The-Majority-of-Nurses-and-Physicians-Say-That-Health-Insurer.pdf"><small class="sm">/system/files/media/file/2023/07/The-Majority-of-Nurses-and-Physicians-Say-That-Health-Insurer.pdf</small></a></p><p><small class="sm"><sup>7</sup> </small><a href="/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf"><small class="sm">/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf</small></a></p><p><small class="sm"><sup>8 </sup>AHA analysis of Levin Associates data on physician medical groups between 2019 and 2023.</small></p><p><small class="sm"><sup>9 </sup> Ibid.</small></p> Wed, 22 May 2024 15:36:09 -0500 Mergers & Acquisitions /news/headline/2024-05-01-aamc-study-examines-impact-health-care-consolidation-states <p>The top three large-group insurers control an average of 82.2% of the market share in each state, nearly twice the combined average market share of each state’s largest health systems, according to a <a href="https://www.aamcresearchinstitute.org/our-work/data-snapshot/why-market-power-matters">study</a> about consolidation in health care released May 1 by the Association of American Medical Colleges. <br><br>"When the market share of an insurer far exceeds the market share of an individual health system — as is the case in most states, according to our analysis — that can negatively impact the amount that insurers are willing to pay hospitals and health systems for patient care," the study notes. </p> Wed, 01 May 2024 16:02:54 -0500 Mergers & Acquisitions