An examination by health economists of price and quality of care aims to provide information to physicians, hospitals, and consumers about the effects of physician-hospital integration.
Hospitals and health systems are falling all over themselves to foster it in their organization. The Patient Protection and Affordable Care Act encourages it.
Everyone, it seems, believes that physician-hospital integration is a win-win in that it improves outcomes and reduces costs.
But the empirical evidence supporting the widely held view is missing.
Now, Rice University health economists say they plan to find out, launching what they call a "first-of-its-kind" study of the association between physician-hospital integration and the quality and price of healthcare.
"The project will provide valuable information to physicians, hospitals, and consumers about the effects of physician-hospital integration," said Vivian Ho, chair in health economics at Rice University's Baker Institute for Public Policy and a co-investigator of the study, in a media statement.
"In addition, analysis results could lead policymakers to modify regulations involving the formation of accountable care organizations, which were introduced into Medicare as part of the Affordable Care Act."
Ho, who is also director of the institute's Center for Health and Biosciences, a professor of economics at Rice, and professor of medicine at Baylor College of Medicine, says the type of coordinated care promised by ACOs should improve patient outcomes while slowing cost growth, but integration could also enable hospitals to raise prices.
Examining both price and quality of care is necessary to determine the implications of physician-hospital integration for consumers.
Ho and her co-investigator, Marah Short, associate director of the Center for Health and Biosciences, will conduct a before-and-after comparison of integration using data for 2008-2013 drawn from the American Hospital Association Annual Survey, the Medicare Hospital Compare database and multiple state databases that collect detailed hospital-level financial reports.
Both say the Medicare Hospital Compare database provides a novel opportunity to examine quality of care measured by timeliness and effectiveness of care for specific conditions, such as acute myocardial infarction, heart failure and stroke care, and readmission rates within 30 days of a patient being treated for such conditions.
The study is at least partially funded by the federal Agency for Healthcare Research and Quality.