Policies to enable physician-led models of care are needed to improve quality, lower costs
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(HealthNewsDigest.com) – WASHINGTON – The American Medical Association (AMA) today submitted a statement on health care industry consolidation to the U. S. House Ways and Means Health Subcommittee during a hearing on the topic. The AMA’s statement examined the current state of consolidation in the health care industry, including areas where changes are needed to protect patients and encourage the success of new models of patient care.
“Existing antitrust policies allow significant consolidation in some areas of our health care system while overly restricting the coordination of care by physicians,” said AMA President Peter W. Carmel, M.D. “It is time to update these policies to allow physicians in all practice sizes the ability to lead and participate in innovative new models of care while protecting patients from anticompetitive practices.”
A full 78 percent of office-based physicians in the United States work in practices with nine physicians or less, and a majority of those are in practices of one to four. Under existing antitrust enforcement policies, these physician practices are effectively prohibited from forming clinically integrated groups that can jointly contract with private payers and participate in care improvement and coordination efforts.
Over the last decade AMA studies have consistently found that a wide majority of local health insurance markets across the nation are highly concentrated, which can mean decreased competition and higher prices for patients. The trend of hospitals merging and acquiring physician practices can also lead to reduced competition and an increase in the amount of care patients receive in more costly inpatient settings.
“We applaud the Ways and Means Committee for examining current policies related to consolidation in health care,” Dr. Carmel said. “We will continue to work with them to design policies that encourage the development of innovative, physician-led new models of patient care designed to improve quality, lower costs and promote competitive health care markets.”
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