So much for economies of scale. Rather than saving money, hospital purchases of physician practices might be driving up health care costs, a survey has found. About 32 percent of respondents to an American College of Physician Executives poll said costs increased after a hospital or health system bought a doctors? group, according to a press release. Only 5 percent said costs went down, while 16 percent said costs stayed the same. The remainder were unsure or said the question didn't apply to their organization. Hospital employment for doctors is becoming the standard, especially in primary care, as Obamacare takes effect. In Cincinnati, the major health systems have hired hundreds of physicians in the last few years, making independent family practitioners or internists hard to find.