To improve care coordination, lower costs and upgrade patient experiences, say hospitals. To raise costs, gain pricing power and steer patient referrals, say skeptics.
Researchers at Stanford University tested those opposing arguments by comparing referral patterns between independent doctors and those working for hospitals.
Ownership by a hospital “dramatically increases” odds that a doctor will admit patients there instead of another, nearby hospital, they found. Worse, from the viewpoint of reformers, it boosts chances that patients will go to higher-cost, lower-quality hospitals.
“One of the things that was most surprising to me about the paper was the quality and cost effect,” said economist Laurence Baker, one of the authors.
While not as pronounced as doctors’ hospital referral pattern, the findings that hospital-physician ownership hurts care quality “head in the direction that might make us concerned,” he said.
The findings were published in August by the National Bureau of Economic Research.
The report is not the final word. More research is needed, the authors say. The 2009 Medicare data they used don’t reflect substantial quality improvements made in many hospitals since then,