Keeping Score: How New York Can Encourage Value-Based Health Care Competition

This Manhattan Institute report, supported by NYHealth, documents the rise in hospital mergers since the passage of the Affordable Care Act (ACA) and their subsequent effects on health care prices and quality, focusing particularly on New York State.

The ACA has dramatically reshaped health care in America—particularly when it comes to industry mergers. As the ACA cuts reimbursements for hospital-based services, hospital mergers are on the rise. These mergers are coming in tandem with major changes in health care prices and delivery. Will consumers and patients benefit—or just be left footing a bigger bill?

The report looks at whether hospital consolidation harms both patients and payers by driving up prices while failing to provide improved care. New York’s $12.8 billion Medicaid reform effort, although taking positive steps to reduce costs and deliver benefits, may make the problem worse by allowing consolidating hospitals to duck antitrust rules.

Although antitrust litigation is an important step to reform, the authors lay out several complementary reforms New York could consider to protect patients and the economy from the ill effects of hospital consolidation while also offering increased competition in the delivery of high-quality, affordable health care services.