Hospital markets are increasingly dominated by fewer, larger hospital systems — the result of mergers that have accelerated the concentration of providers and insurers. Such consolidation has been shown to lead to higher commercial health care prices, without corresponding improvements in quality. Furthermore, the effect of hospital mergers on the care of low-income patients, such as people covered by Medicaid, remains largely unknown. In a new JAMA Health Forum study, LDI Senior Fellow Eric T. Roberts, NYU Grossman School of Medicine Assistant Professor Sunita Desai, and colleagues looked at whether hospital mergers were associated with changes in obstetric outcomes and the hospitals where pregnant Medicaid enrollees were admitted for labor and delivery. Using a difference-in-differences analysis, the team found that hospital mergers were linked to increased travel distances, shifts toward admission to safety-net hospitals and away from hospitals with NICUs in urban areas, shifts toward hospitals with NICUs in rural areas, and a small worsening in one obstetric trauma measure.
In a social media landscape shaped by hashtags, algorithms, and viral posts, nurse leaders must decide: Will they let the narrative spiral, or can they adapt and join the conversation?
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