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Health care system merger

Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
Sherry A Glied, Stuart H Altman
The United States relies on competition to balance costs and quality in the health care system. But concentration is increasing throughout the hospital, physician, and insurer markets. Midsize community hospitals face declining demand and growing competition from both larger hospitals and smaller freestanding diagnostic and surgical centers, leaving the midsize hospitals vulnerable to closure or merger with other facilities. Competition among insurers has been limited by the development of hospital systems that extend the bargaining power of "must-have" hospitals (those perceived to provide the best care for complex and less common conditions) across local health care markets...
September 1, 2017: Health Affairs
Matthew Menear, Michel Gilbert, Marie-Josée Fleury
Objective The objectives of this review were to identify and compare major international initiatives aiming to integrate mental health services in primary care and to summarize the lessons learned for similar integration efforts in the province of Quebec, Canada.Methods We conducted a narrative review of the literature guided by a conceptual framework drawn from the literature on integrated care. We identified relevant initiatives to support primary mental health care integration through Pubmed searches and through previous systematic reviews on this topic...
December 0: Santé Mentale Au Québec
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
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