Solo physicians and smaller medical groups that struggle to pay for an electronic health record system to comply with government reporting requirements have sold out to hospitals, and the resulting consolidation had raised prices for consumers, according to the report.
The administration also blames the Affordable Care Act for the mandated cuts in hospital payments, noting that new regulatory burdens made it difficult for smaller institutions to go it alone.
"Hospital mergers are booming, leading to horizontal integration, and large hospitals are buying up physicians' practices and outpatient service providers to form large, vertically integrated healthcare networks," the report said.
The conclusions regarding the burden on small physician groups and solo practitioners almost mirror those published in the Journal of the American Medical Informatics Association on Jan. 23. Titled "Meaningful Use's benefits and burdens for US family physicians" the study took stock of the upsides and downsides of the program.
In 2015, 480 US family physicians responded to a JAMIA survey. The results: Eighteen of 31 meaningful use criteria were perceived as useful for more than half of patient encounters, with 13 of those being useful for more than two-thirds. Thirteen criteria were useful for less than half of patient encounters. Four useful criteria were reported as having a high compliance burden.
The JAMA study concluded that "for many physicians, meaningful use created a significant practice burden without clear benefits to patient care."
Trump's report also foretold another report, due in the spring of 2018, in which it will identify the policies, at both the federal and state levels, that are fueling hospital consolidation and price increases.
"Hospital competition leads to lower prices and higher quality," the Trump report said. "This is consistent with the Administration's deregulatory agenda, which has already withdrawn, made inactive, and delayed hundreds of economically destructive regulations."