Consolidation is on the rise across healthcare, and ASCs are no different. But how does consolidation impact the future and function of ASCs?
1. Cost of care. According to the National Conference of State Legislatures, while some research indicates that consolidation can increase efficiency, many studies conclude that consolidation results in higher healthcare prices, with no indication that higher prices result in improved care.
While ASCs remain largely fragmented, healthcare giants like Optum and Tenet have made a number of moves to acquire ASC chains and physician practice groups. According to KFF, one study that used private insurer data found that an increase in physician-hospital integration was associated with an average price increase of 14% for the same service. Those findings were consistent with another study that found that a large increase in physician-hospital vertical integration was associated with an increase in outpatient prices, too.
2. Possible negative impacts on healthcare access. According to The Century Foundation, consolidation is associated with worse and less equitable access to care. From 1998 to 2021, hospital consolidation resulted in 1,887 mergers and reduced the number of hospitals in the U.S by 25%. While ASC consolidation is happening slowly as achieving economies of scale becomes more difficult , corporate owners are more likely to shutter services or facilities that are less profitable in order to protect their bottom line. This often disproportionately impacts rural communities and communities of color, according to the report.
3. Quality of care and patient experience. While the promise of efficiency and ease of coordination still looms large in conversations around consolidation, some physicians and patients express concern about whether corporate chains are able to deliver the personalized care that people flock to ASCs to receive.
"If you're a private equity firm, and your goal is to take this practice and reduce costs and to increase revenue, then to turn around and sell it for a profit in three, five or seven years, it's hard to identify where that is aligned with the goal of a physician, which is to have relationships with patients that are meaningful and improve their health," David Wild, MD, vice president and regional chief medical officer of Johnson City, Tenn.-based Ballad Health's southern region, told Becker's.
"No matter how you look at it, it's concerning. While there are a number of variables to consider, these purchases are definitely changing the healthcare landscape, and it will be interesting to see how it all plays out," he added.