Has the government push towards Accountable Care Organizations (ACOs) caused hospitals to merge and buy up doctor practices?

Background Information

Debate Question:This is what a short summary question would look like.

Mergers of hospitals and doctor practices have increased in recent years. This has reduced the number of health systems in many regions, eliminated smaller physician practices, and led to the majority of US doctors now being salaried employees rather than owning their own practices. Some critics argue that this has contributed to a corporate approach to medicine and less focus on patient needs. Many also are concerned that when there are a smaller number of larger hospital systems, there is less competition, causing prices to rise.
in favor
against

For the past several years hospitals have been merging and buying medical practices at a rapid pace in markets across the country so they can coordinate care and manage budgets within an ACO framework.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Just because we’ve seen more mergers since the ACA and accountable care were introduced doesn’t mean that one caused the other.

Zetema PanelistZetema Panelist Against
  • Good Point +1

More provider mergers have resulted directly from the government’s emphasis on ACOs, which need to integrate multiple hospitals and physician practices in a region in order to have the scale to succeed.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Mergers have been caused not by ACOs, but by changing market dynamics and the need to invest in electronic health records, which is difficult for small hospitals and practices to do.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Greater hospital concentration in a region has been shown to correlate with higher hospital prices, as health systems gain negotiating leverage compared with payers.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Having hospitals and doctors integrated into one organization doesn’t necessarily raise costs. Integrated health systems such as Kaiser Permanente, Geisinger Health System, and Mayo are relatively low-cost providers that deliver some of the highest quality care in the country.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Mergers, which lead to price increases, have become so numerous and dangerous for some markets with limited competition that the Justice Department has felt compelled to step in and stop some of them.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

This trend has been going on for 30 years, well before ACOs were developed, so ACOs can’t be the primary factor underlying consolidation.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Mergers have led to the “corporatization” of medicine, with a focus on profits over patients.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Whether or not the ACO program has encouraged mergers, the trend toward healthcare as a business was happening for decades before the law was passed.

Zetema PanelistZetema Panelist Against
  • Good Point +1

What do you think?

Has the government push towards Accountable Care Organizations (ACOs) caused hospitals to merge and buy up doctor practices?

Has the government push towards Accountable Care Organizations (ACOs) caused hospitals to merge and buy up doctor practices?

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