Bigger Is Better? Non Too Then Fast!
Tuesday, November 24, 2020
Here's a useful report from the Leonard Davis Institute of Health Economics at the University of Pennsylvania:
A novel study past times LDI Senior Fellow Lawton Burns too colleagues challenges the conventional wisdom nearly the societal benefits too comparative advantages of integrated delivery networks (IDNs). A literature review too detailed analysis of fiscal too character indicators constitute “scant evidence” of improved quality, lower cost per case, or greater societal benefit. From the abstract:
Looking at the benefits to society, the authors constitute that in that location is evidence that IDNs accept raised MD costs, infirmary prices too per capita medical assist spending; looking at the benefits to the providers, the evidence besides showed that greater investments inwards IDN evolution are associated amongst lower operating margins too render on capital. As business office of this report, the authors conducted a novel analysis of xv of the largest IDNs inwards the country. While information on infirmary surgical operation at the IDN aeroplane are scant, the authors constitute no human relationship betwixt the grade of infirmary marketplace concentration too IDN operating profits, betwixt the size of the IDN’s bed complement or its cyberspace collected revenues too operating profits, no divergence inwards clinical character or security scores betwixt the IDN’s flagship infirmary too its major in-market competitor, higher costs of assist inwards the IDN’s flagship infirmary versus its in-market competitor, too higher costs of assist when to a greater extent than of the flagship hospital’s revenues were at risk.
In a related piece at Modern Healthcare, the authors conclude:
After decades of strenuous policy advocacy, it is notwithstanding non clear that, inwards the representative of the IDN, the whole is greater than the amount of its parts, or that policymakers should live on encouraging farther IDN formation.
I portion the authors' skepticism nearly this direction inwards wellness assist policy.
A novel study past times LDI Senior Fellow Lawton Burns too colleagues challenges the conventional wisdom nearly the societal benefits too comparative advantages of integrated delivery networks (IDNs). A literature review too detailed analysis of fiscal too character indicators constitute “scant evidence” of improved quality, lower cost per case, or greater societal benefit. From the abstract:
Looking at the benefits to society, the authors constitute that in that location is evidence that IDNs accept raised MD costs, infirmary prices too per capita medical assist spending; looking at the benefits to the providers, the evidence besides showed that greater investments inwards IDN evolution are associated amongst lower operating margins too render on capital. As business office of this report, the authors conducted a novel analysis of xv of the largest IDNs inwards the country. While information on infirmary surgical operation at the IDN aeroplane are scant, the authors constitute no human relationship betwixt the grade of infirmary marketplace concentration too IDN operating profits, betwixt the size of the IDN’s bed complement or its cyberspace collected revenues too operating profits, no divergence inwards clinical character or security scores betwixt the IDN’s flagship infirmary too its major in-market competitor, higher costs of assist inwards the IDN’s flagship infirmary versus its in-market competitor, too higher costs of assist when to a greater extent than of the flagship hospital’s revenues were at risk.
In a related piece at Modern Healthcare, the authors conclude:
After decades of strenuous policy advocacy, it is notwithstanding non clear that, inwards the representative of the IDN, the whole is greater than the amount of its parts, or that policymakers should live on encouraging farther IDN formation.
I portion the authors' skepticism nearly this direction inwards wellness assist policy.