No Evidence Found for Health Care Integration Improving Value of Health Care

THURSDAY, Jan. 9, 2025 (HealthDay News) — Evidence is lacking to support integration for improving the value of health care, according to a review published online Dec. 5 in the Journal of the American College of Surgeons.

Bhagwan Satiani M.D., from The Ohio State University in Columbus, and colleagues conducted a systematic literature review for articles published from 1990 to 2024 on integration to examine whether its reputation for enhancing the value of health care by reducing price and cost/spending and improving quality is justified. The primary inclusion criteria were horizontal integration (HI; joining two or more hospitals) or vertical integration (VI; merging of physicians and hospitals) and reporting at least one measure of value.

The researchers found that neither HI nor VI resulted in consistent and significant improvements in price, cost/spending, or quality of health care delivery. A total of 37 articles met the inclusion criteria; mixed results were seen for any form of integration. Price increases were reported in 93 percent of 14 studies about price; 81 percent of 16 studies about cost/spending showed increases or no change; and reduction or no change from integration was seen in 77 percent of 26 studies about quality.

“The pursuit of true quality improvement and cost reduction is the future of the U.S. health care system but cannot be achieved through mergers alone without the infrastructure, methodology and discipline to achieve this state of value,” the authors write.

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