ACA Repeal Would Squeeze For-Profit Hospitals

While the investments for-profit hospital operators are making now could reduce their profit margins in the next year or two, the report concludes that the "increased spending will benefit them in the longer term and provide competitive advantages over other hospitals."

Diaz is less sure about the benefits of employing physicians and acquiring physician groups. Those investments, he says, are motivated by the creation of accountable care organizations and new payment models such as bundled payments and "may take a longer time" to produce a return. Still, the physician practices will "continue to provide the for-profit hospital operators a means of maintaining patient volumes within their systems even if the healthcare law is repealed," says the report.

HealthLeaders Media released in January a survey of hospital administrators that revealed that 59% of the respondents have a high interest in acquiring physician groups and 56% of healthcare leaders have a specific team dedicated to hospital-physician practice acquisition.

Despite its shortcomings, the demise of the full ACA "would create an even greater sense of uncertainty" for for-profit operators because healthcare reform would once again "be open to any number of proposals," says the report.