PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Hospital acquisitions leading to increased patient costs

2014-10-21
(Press-News.org) Berkeley — The trend of hospitals consolidating medical groups and physician practices in an effort to improve the coordination of patient care is backfiring and increasing the cost of patient care, according to a new study led by the University of California, Berkeley.

The counterintuitive findings, published today (Tuesday, Oct. 21) in the Journal of the American Medical Association, come as a growing number of local hospitals and large, multi-hospital systems in this country are acquiring physician groups and medical practices.

"This consolidation is meant to better coordinate care and to have a stronger bargaining position with insurance plans," said study lead author James Robinson, professor and head of health policy and management at UC Berkeley's School of Public Health. "The movement also aligns with the goals of the Affordable Care Act, since physicians and hospitals working together in 'accountable care organizations' can provide care better than the traditional fee-for-service and solo practice models. The intent of consolidation is to reduce costs and improve quality, but the problem with all this is that hospitals are very expensive and complex organizations, and they are not known for their efficiency and low prices."

Robinson teamed up with study co-author Kelly Miller, program analyst at Integrated Healthcare Association, a non-profit organization that promotes healthcare quality improvement, accountability and affordability in California.

The researchers analyzed four years of data, from 2009 to 2012, on 158 major medical groups and 4.5 million patients in California. Groups were put into three categories: owned by physicians, owned by a local hospital or hospital system, or owned by a large hospital system that spans multiple geographic markets in the state.

The measure of costs included physician visits, inpatient hospital admissions, outpatient surgery and diagnostic procedures, drugs, and all other forms of medical care except for mental health services. (The researchers did not have data on mental health services since they are paid for separately.)

After controlling for such factors as the mix of severely ill patients and geographic differences in cost, the researchers found that per patient expenditures were 19.8 percent higher for physician groups in multi-hospital systems compared with physician-owned organizations. Groups owned by local hospitals were better, but per patient costs still ran 10.3 percent higher compared with physician-owned groups.

Why would consolidation lead to increased costs? It could be that once a medical group has been acquired, physicians in those groups are expected to admit their patients to the high-priced hospital, Robinson said.

"Hospital-owned medical groups usually are expected to conduct ambulatory surgery and diagnostic procedures in the outpatient departments of their parent hospital, but hospital outpatient departments are much more costly and charge much higher prices than freestanding, non-hospital ambulatory centers," he said.

Robinson said that public policy should not encourage mergers and acquisitions as a means of promoting collaboration. Instead, he said, policymakers should consider supporting the use of bundled payments for hospitals and physicians to improve coordination of care.

"Hospitals are an essential part of the health care system, but they should not be the center of the delivery system," said Robinson. "Rather, physician-led organizations based in ambulatory and community settings are likely to be more efficient and provide cheaper care."

The study authors noted that their findings are limited to California, and that further studies should be done using data from other states.

"Nevertheless, these findings are important since California is the nation's leader in terms of having physicians participate in large medical groups that already perform the functions ascribed to 'accountable care organizations' by the Obama administration," said Robinson.

INFORMATION:

The Robert Wood Johnson Foundation provided support for this research.



ELSE PRESS RELEASES FROM THIS DATE:

This week from AGU: Rainfall and landslide risk, lava lake, winds hasten glacial melting

2014-10-21
From AGU's blogs: How rain falls – not just how much – may alter landslide risk New research finds that it's not just the amount of rain that falls on a hillside, but the pattern of rainfall that matters when trying to determine how likely a slope is to give way. This new information could improve forecasts of landslides, which are typically hard to predict, said the scientists conducting the research. Different rainfall patterns—a short, heavy deluge, a light, steady downpour, or sporadic showers—will trigger different numbers of landslides ...

Osteoporosis screening guidelines miss many younger post-menopausal women

2014-10-21
To reduce the risk of bone fractures and the complications arising from them, the United States Preventive Services Task force (USPSTF) recommends that all women age 65 and older be tested and treated for low bone mineral density. The task force also recommends that postmenopausal women aged 50 to 64, get bone mineral density screenings if their 10-year probability of suffering a hip, vertebral, humerus or wrist fracture is 9.3 percent or greater, based on the Fracture Risk Assessment Tool. A new UCLA-led study published in The Journal of Clinical Endocrinology & Metabolism, ...

New treatment resolves a hazardous airway complication in child with heart disease

New treatment resolves a hazardous airway complication in child with heart disease
2014-10-21
Philadelphia, Oct. 21, 2014 – A case study published recently in the journal Pediatrics describes an innovative, minimally invasive procedure that treated plastic bronchitis, a potentially life-threatening disease, in a six-year-old boy with a heart condition. Using new lymphatic imaging tools and catheterization techniques, physician-researchers eliminated bronchial casts, which are an accumulation of lymphatic material that clogged the child's airway. "Our technique represents a new treatment option for plastic bronchitis, which is a rare but often fatal complication ...

Immersed in violence: How 3-D gaming affects video game players

2014-10-21
COLUMBUS, Ohio – Playing violent video games in 3-D makes everything seem more real – and that may have troubling consequences for players, a new study reveals. Researchers found that people who played violent video games in 3-D showed more evidence of anger afterward than did people who played using traditional 2-D systems -- even those with large screens. The higher anger in 3-D players was connected to the fact that, compared to 2-D players, they were more likely to feel they were "immersed in the game," said Brad Bushman, co-author of the study and professor ...

Study shows how troubled marriage, depression history promote obesity

2014-10-21
COLUMBUS, Ohio – The double-whammy of marital hostility and a history of depression can increase the risk for obesity in adults by altering how the body processes high-fat foods, according to new research. In the study, men and women with a history of depression whose arguments with spouses were especially heated showed several potential metabolic problems after eating a high-fat meal. They burned fewer calories and had higher levels of insulin and spikes of triglycerides – a form of fat in the blood – after eating a heavy meal when compared to participants ...

Researchers identify new cell signaling pathway thought to play role in rheumatoid arthritis

2014-10-21
A new study by researchers at Hospital for Special Surgery (HSS) identifies a new cell signaling pathway that contributes to the development and progression of inflammatory bone erosion, which occurs in patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a systemic inflammatory autoimmune disease that affects millions of adults worldwide. Bone erosion in joints is a major cause of disability in RA patients. The study, titled "RBP-J imposes a requirement for ITAM-mediated costimulation of osteoclastogenesis," was published online in the Journal of Clinical ...

In disease outbreak management, flexibility can save lives and money

In disease outbreak management, flexibility can save lives and money
2014-10-21
A new approach for responding to and managing disease outbreaks is being proposed by a team of epidemiologists led by two Penn State University researchers. The team's flexible approach could save many lives and millions of dollars. The approach, called "adaptive management," allows decision-makers to use knowledge they gain during an outbreak to update ongoing interventions with the goal of containing outbreaks more quickly and efficiently. Current efforts to prevent or stem such outbreaks may fall short because of uncertainty and limited information about the real-time ...

Flexibility in disease outbreak management could save lives and money

2014-10-21
Research by a team of epidemiologists from the UK and the USA has proposed a new approach for responding to and managing disease outbreaks. They say lives and money could be saved if decisions are adapted to relevant information about the dynamics of the current crisis and not based on retrospective analyses of prior crises, trials and interventions. Dr Michael Tildesley, a lecturer in infectious disease modelling in the School of Veterinary Medicine and Science at The University of Nottingham and co-author of the paper, said: "Organisations involved in the outbreak of ...

Disease outbreak management -- flexibility can save lives and money

2014-10-21
What is the best way to handle a disease outbreak? Current efforts to prevent or stem such outbreaks may fall short because of uncertainty and limited information about the real-time dynamics of the specific disease outbreak. A team of epidemiologists, led by two Penn State University researchers, proposes a new approach for responding to and managing disease outbreaks -- a flexible approach that could save many lives and millions of dollars. The approach, called "adaptive management," allows decision-makers to use knowledge they gain during an outbreak to update ongoing ...

Most published medical research is false; Here's how to improve

2014-10-21
In 2005, in a landmark paper viewed well over a million times, John Ioannidis explained in PLOS Medicine why most published research findings are false. To coincide with PLOS Medicine's 10th anniversary he responds to the challenge of this situation by suggesting how the research enterprise could be improved. Research, including medical research, is subject to a range of biases which mean that misleading or useless work is sometimes pursued and published while work of value is ignored. The risks and rewards of academic careers, the structures and habits of peer reviewed ...

LAST 30 PRESS RELEASES:

Climate change taking toll on teen mental health, study finds

Hanyang University researchers develop novel sensor for continuous endoleak monitoring

Seoul National University of Science and Technology researchers discover breakthrough materials for removing pharmaceuticals from wastewater

Epigenetic “scars”: Unveiling how childhood trauma affects our genes

Where you live may affect your brain health, new study finds 

Frontiers and World Economic Forum unveil top technologies to accelerate global climate and planetary health solutions

‘How drunk do you feel?’: Ozempic, Wegovy may help reduce alcohol use, Virginia Tech researchers find

Divine punishment as an ancient tool for modern sustainability

Hotter does mean wetter

Internal migrants in the U.S. age with fewer disabilities, study finds

Anna Krylov and Mikhail Yampolsky are the new George Gamow award laureates

Methane from overlooked sources higher than predicted in Osaka

World’s largest rays may be diving to extreme depths to build mental maps of vast oceans

Can we hear gravitational-wave "beats" in the rhythm of pulsars?

New survey shows many are unaware of advancements in obstetrics care

New combination therapy shows promise for aggressive lymphoma resistant to immunotherapy

Photocatalytic olefin double bond cleavage acylation

Unveiling the impact of compound drought and wildfire events on PM2.5 air pollution in the era of climate change

A bioadhesive sponge inspired by mussels and extracellular matrix offers a new way to stop internal bleeding

Poorer health linked to more votes for Reform UK, 2024 voting patterns suggest

Loneliness and social isolation linked to heightened risk of death in those with cancer

Ditch ‘shrink it and pink it’ approach to women’s running shoes, manufacturers urged

Domestic abusers forge ‘trauma bonds’ with victims before violence begins

UK food needs radical transformation on scale not seen since Second World War, new report finds

New AI tool makes medical imaging process 90% more efficient

Nitrogen-fortified nanobiochar boosts soil health and rice productivity

Generative art enhances virtual shopping experience

Fluid-based laser scanning for brain imaging

Concordia study links urban heat in Montreal to unequal greenspace access

Hidden patterns link ribosomal RNAs to genes of the nervous system

[Press-News.org] Hospital acquisitions leading to increased patient costs