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Hospital mergers can create new areas of patient risk, study finds

Mergers and acquisitions can result in economy of scale and other financial benefits -- but patient access and services issues can go unaddressed.

Jeff Lagasse, Associate Editor

Mergers and acquisitions are all the rage as consolidation sweeps across the healthcare landscape, but does clinical quality suffer as a result? 

New findings published the Journal of the American Medical Association suggest that, unfortunately, it just might, due largely to mergers being driven by business and not the clinical side of hospitals.

[Also: Hospital mergers up 13%, says Kaufman Hall]

To be sure, mergers and acquisitions can result in economy of scale and other financial benefits, but because that's the focus, aspects like patient access and services sometimes go unaddressed, which can lead to certain risks, the report said.

For one, combining businesses means all patients overseen by those entities are now under a single umbrella, and because different patients have different needs, proper care may require the combined business to invest in new tools. An example cited by the authors is the non-English speaking population, whose care may suffer if the newly-consolidated provider lacks the resources to attend to such needs.

Then there's infrastructure. Supply chains, technologies and electronic health systems may be different at every institution, and if they're not unified, care issues can arise. On top of that, the authors found there can be a lack of consistency in terms of doctors, who are often shuffled around and moved to new sites after a merger.

To get around some of these potential patient safety concerns, the researchers suggested tweaking parts of the disparate EHR systems that are non-interoperable to ensure they function properly in the new framework. 

Leaders should also establish workflows for any IT tools and equipment, and limit, to the extent possible, the number of clinicians who are traveling to new sites, which can alter the workflow and practice environment in ways that are potentially detrimental to the patient -- especially if the clinicians don't fully grasp the type of care provided at each site.

M&A activity has been brisk so far this year. Philadelphia healthcare giant Jefferson Health, for example, plans to potentially merge with Einstein Health, and Dignity Health and Catholic Health Initiatives are also inching closer to a merger that would form the second-largest nonprofit health system in the country. And Partners Healthcare, which includes Massachusetts General Hospital and Brigham and Women's Hospital, is finalizing plans to acquire a major Rhode Island system, Care New England.

Twitter: @JELagasse
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