During 1996 and 1997, researchers at the Economic and Social Research Institute, led by Jack A. Meyer, PhD, examined the St. Louis and Philadelphia hospital markets, which experienced extensive merger activity in the early 1990s, to assess whether horizontal integration combined with purchaser pressure can shrink the excess capacity in a hospital system.
Located in Washington, the institute is a nonprofit, nonpartisan organization that specializes in health and social policy research.
This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).
Key Findings: Researchers reported the following findings in a Findings Brief available on the HCFO website:
- Newly created hospital networks tend to evolve through five stages. These include:
- Loose affiliation.
- Administrative (e.g., marketing, human resources) services consolidation.
- Cultural integration, particularly of physicians.
- Clinical (e.g., cardiology and other specialties) services consolidation.
- Closure of inefficient and redundant hospitals.
- In both cities, many of the merged hospitals have improved efficiency since 1993.
- The merged hospitals in St. Louis and Philadelphia have not consolidated specialized clinical services, nor have they reduced excess hospital beds or closed facilities.
- Improving power in negotiations with managed care plans through increased size, rather than operational efficiency, was the impetus for many hospital mergers in both St. Louis and Philadelphia.
Changes in Health Care Financing and Organization Project Results
Individual project results from the RWJF national program, Changes in Health Care Financing and OrganizationRead the Program Results for Changes in Health Care Financing and Organization
- About this grant
Executive Nurse Fellow Jerry Mansfield explains why the University Hospital and the Richard M. Ross Heart Hospital do not have a BSN-only hi...
We create new opportunities for better health by investing in health where it starts—in our homes, schools, and jobs.
The What's Next Health series features leading thinkers and visionaries. Stanford social scientist & innovator BJ Fogg discusses his model f...
RWJF Nurse Faculty Scholar Jennifer Bellot writes about losing her grandmother to complications from a medical error.
Developing small community homes as alternatives to nursing homes, this radical, new national model for skilled nursing care returns control...
America is not getting good value for its health care dollar. These resources explore issues of cost and value of health care.
Helping us understand what’s driving high health care costs is why we need more transparency in the prices, costs and quality of health care...
Patrick M. Krueger recently co-authored a study that examines the characteristics and mortality risks of nondrinker subgroups to explain why...
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
By Roy L. Simpson, RN, C, FAAN, DPNAP, Vice President, Nursing, Cerner Corporation Technology erases the traditional boundaries of space and...
A new study finds healthier school meals standards could mean lower obesity rates among lower-income children. Read a Q&A with the author.
Judith Halstead, president of the National League for Nursing, writes about the role of nursing education in realizing a transformed health ...