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Health care system merger

Monica Giancotti, Annamaria Guglielmo, Marianna Mauro
BACKGROUND: National Health Systems managers have been subject in recent years to considerable pressure to increase concentration and allow mergers. This pressure has been justified by a belief that larger hospitals lead to lower average costs and better clinical outcomes through the exploitation of economies of scale. In this context, the opportunity to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources...
2017: PloS One
Pedro Pita Barros
We review the role of competition among healthcare providers in Portugal, which has a public National Health Service (NHS) at the core of the health system. There is little competition among healthcare providers within the NHS. Competition among NHS primary care providers is hindered by excess demand (many residents in Portugal do not have a designated family doctor). Competition among NHS hospitals has been traditionally limited to cases of maximum guaranteed waiting time for surgery being exceeded. The Portuguese Competition Authority enforces competition law...
February 2017: Health Policy
Maureen Schneider
As a result of the Affordable Care Act, innovative strategies must be developed and initiated to work with the Affordable Care Act in order to diminish fragmentation of care delivery and thereby improve quality and reduce costs. It is imperative for health care organizations to explore options from mergers and acquisitions to affiliation agreements in order to prepare for business transformation. Since financial strength combined with independent governance and retention of cultural identity may be optimal, a legal transactional structure such as an affiliation is sometimes the best course of action for a health system...
October 2016: Nursing Administration Quarterly
Pamela Smith Elzy
Today's dynamic health care environment is exceedingly complex, and health care facilities across the United States are struggling to respond to changes in technology, health care reimbursement, the Affordable Care Act, and the much-anticipated nursing shortage. Mergers, acquisitions, and integrations are the current health care reality. These are proposed to increase efficiency, efficacy, quality, satisfaction, and safety while effectively reducing cost to the consumer and stabilizing the economy of the health care system...
October 2016: Nursing Administration Quarterly
Marcia Faller, Jim Gogek
The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector...
October 2016: Nursing Administration Quarterly
Sylvain Trepanier, Jeannette T Crenshaw, Patricia S Yoder-Wise
Today's nurse executive is likely to find himself or herself in the middle of a merger, acquisition, and/or partnership (MAP). This is the result of health care agencies vying for market share in the midst of stiff competition, as well as decreased reimbursement in a rapidly changing payment system. The phenomenon of MAPs is fueled by the focus on care coordination and population health management. To be prepared for the ongoing and increasing MAP activity, nurse executives need to develop the skill of risk taking as an essential competency for leading change...
October 2016: Nursing Administration Quarterly
Marissa J Noles, Kristin L Reiter, Jonathan Boortz-Marx, George Pink
The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A...
November 2015: Journal of Healthcare Management / American College of Healthcare Executives
Julio Arevalo-Perez, Manuel Paris, Michael M Graham, Joseph R Osborne
Nuclear Medicine (NM) has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become "Molecular Imaging." Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle-imaging, radiopharmaceuticals, and instrumentation. Since the foundation of the American Board of NM, the practice of NM and the process toward certification have undergone major revisions...
January 2016: Seminars in Nuclear Medicine
Simon Schurr
Driven by the changing reimbursement climate from volume to value-based, hospital systems must initiate technology and training to insure that communications between all HCPs involved with a given patient are coordinated and all test results and care plans are immediately available at every point of care in the system. Since the enactment of the Patient Protection and Affordable Care Act (PPACA), there has been intense pressure on hospitals and health systems to reduce costs. Many hospitals are responding by merging and buying doctors' practices, while some are beginning to offer their own health plans for the first time and setting up accountable care organizations that would provide coordinated high quality health care for large groups of patients...
2015: World Hospitals and Health Services: the Official Journal of the International Hospital Federation
Rakesh Sarwal
BACKGROUND: Universal Health Coverage (UHC) is now recognized as a goal of all health systems, irrespective of income levels. In the absence of a one-size solution, each country has to develop strategies suited to its circumstances. How does the Central Government Health Scheme (CGHS) stand up to the goals and global experience of UHC, and what can be done to make it a model? METHODS: I relied on publicly available documents to identify key features of UHC, and relate it to the architecture of and practices in CGHS...
January 2015: National Medical Journal of India
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
India has a population of 1.21 billion people and there is a high degree of socio-cultural, linguistic, and demographic heterogeneity. There is a limited number of health care professionals, especially doctors, per head of population. The National Rural Health Mission has decided to mainstream the Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system of indigenous medicine to help meet the challenge of this shortage of health care professionals and to strengthen the delivery system of the health care service...
April 2015: Journal of Traditional and Complementary Medicine
Robert Berenson
Prices are the major driver of why the United States spends so much more on health care than other countries do. The pricing power that hospitals have garnered recently has resulted from consolidated delivery systems and concentrated markets, leading to enhanced negotiating leverage. But consolidation may be the wrong frame for viewing the problem of high and highly variable prices; many "must-have" hospitals achieve their pricing power from sources other than consolidation, for example, reputation. Further, the frame of consolidation leads to unrealistic expectations for what antitrust's role in addressing pricing power should be, especially because in the wake of two periods of merger "manias" and "frenzies" many markets already lack effective competition...
August 2015: Journal of Health Politics, Policy and Law
Charles R McConnell
Once a cottage industry consisting of many scattered providers, health care has become an industry of large organizations and multi-institutional systems. Various organizational combinations continue to occur, especially in the form of mergers, affiliations, and the creation and expansion of health care systems. In the midst of this ongoing dramatic change, the role of the individual manager remains essentially unchanged in concept, but the arena in which that role is pursued is rapidly changing. Areas of responsibility are becoming broader, the groups overseen by individual managers are becoming larger, and many of the older "principles" of management are being tested and strained...
April 2015: Health Care Manager
Claudia M Witt, Marion Pérard, Brian Berman, Susan Berman, Timothy C Birdsall, Horst Defren, Sherko Kümmel, Gary Deng, Gustav Dobos, Atje Drexler, Christine Holmberg, Markus Horneber, Robert Jütte, Lori Knutson, Christopher Kummer, Susanne Volpers, David Schweiger
BACKGROUND: An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically...
2015: Patient Preference and Adherence
Scott A Lorch, Ashley E Martin, Richa Ranade, Sindhu K Srinivas, David Grande
The Affordable Care Act is triggering an increase in hospital consolidation and mergers. How other hospitals respond to these disruptions in supply could influence patient outcomes. We examined the experience of Philadelphia County, Pennsylvania (coterminous with the city of Philadelphia), where thirteen of nineteen hospital obstetric units closed between 1997 and 2012. Between October 2011 and January 2012 we interviewed twenty-three key informants from eleven hospitals (six urban and five suburban) whose obstetric units remained open, to understand how the large number of closures affected their operations...
December 2014: Health Affairs
Jessica Mulligan
The financial exuberance that eventually culminated in the recent world economic crisis also ushered in dramatic shifts in how health care is financed, administered, and imagined. Drawing on research conducted in the mid-2000s at a health insurance company in Puerto Rico, this article shows how health care has been financialized in many ways that include: (1) privatizing public services; (2) engineering new insurance products like high deductible plans and health savings accounts; (3) applying financial techniques to premium payments to yield maximum profitability; (4) a managerial focus on shareholder value; and (5) prioritizing mergers and financial speculation...
March 2016: Medical Anthropology Quarterly
Henrik Vogt, Elling Ulvestad, Thor Eirik Eriksen, Linn Getz
RATIONALE, AIMS AND OBJECTIVES: The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges...
December 2014: Journal of Evaluation in Clinical Practice
Robert L Sautter, Richard B Thomson
The manner in which medical care is reimbursed in the United States has resulted in significant consolidation in the U.S. health care system. One of the consequences of this has been the development of centralized clinical microbiology laboratories that provide services to patients receiving care in multiple off-site, often remote, locations. Microbiology specimens are unique among clinical specimens in that optimal analysis may require the maintenance of viable organisms. Centralized laboratories may be located hours from patient care settings, and transport conditions need to be such that organism viability can be maintained under a variety of transport conditions...
May 2015: Journal of Clinical Microbiology
Sean West
Over 50% of physician offices and group practices are replacing their electronic health record (EHR) systems. Dissatisfaction with first-generation systems, physician practice mergers, and hospital acquisitions are all driving the move from legacy EHRs to newer, more sophisticated software. With this painful decision comes the same challenge experienced with a medical practice's original EHR implementation--getting data into the new system. However, now practices have decades of data, terabytes of information, and multiple vendors to manage...
November 2013: Journal of Medical Practice Management: MPM
Paul M Roman
OBJECTIVE: This article traces the evolution of alcohol-related social policy over the past 75 years. METHOD: The literature was reviewed and is critically discussed. RESULTS: The social history of alcohol policies over the last 75 years began with the scientific approach to alcohol in the 1930s and later shifted to a central interest in the disease of alcoholism. Beginning with the National Council on Alcoholism Education, advocates struggled to "mainstream" treatment for this disease into the health care system...
2014: Journal of Studies on Alcohol and Drugs. Supplement
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