You may have read some of our prior coverage regarding consolidation of hospital systems across the country. Recently in Washington we have seen the Virginia Mason system consumed by the giant CommonSpirit Health System. We have discussed before that the mergers are often framed as improvements for patients that do not always come to fruition. There is a recent story out of California that tells of an Orange County Hospital fighting against consolidation.
The claimed benefits of consolidation include wider in-system offerings, improvement in quality of care, and lower costs to the consumer. The wider in-system offerings become revenue drivers for these systems, quality of care does not in fact improve, and healthcare costs are often driven UP by consolidation.
Add another argument against consolidation: bureaucracy interferes with clinical decision making.
A hospital in Orange County that has spent eight years in the Providence health system wants out. The hospital is arguing that its relationship with Providence constrains its ability to meet the needs of its Orange County patient population. To wit, the hospitals doctors complain that the Providence system depends on standardized treatment decisions determined by the Epic Electronic Health Records (EHR) system conflicts with the doctors’ own judgment. Essentially: the hospitals doctors bristle that a percentage of their decision making has been replaced by formulaic standardized one-size-fits-most treatment decisions.
Additionally, the hospital is one of several who are seeking to uncouple itself from the Catholic health directives of the US Conference of Bishops. In Washington, Yakima’s Virginia Mason Memorial Hospital announced its intention to separate from the Virginia Mason Health System in order to avoid being consumed by the CHI Franciscan system, itself part of the massive Catholic CommonSpirit Health system.
It is likely consolidation will continue for the foreseeable future. We are seeing more and more, though, that the drive to grow hospital systems is not to improve patient care or drive down costs: it is to generate ever increasing returns.
