3. The ever-consolidating health care industry
The same question we posed at the start of 2018 is just as relevant going into this year: Is the never-ending cycle of health care consolidation good for patients — for their wallets and the quality of their care?
The big picture: A persuasive body of research shows that hospital system mergers and hospital acquisitions of doctor practices raise costs, although the American Hospital Association argues otherwise.
- Combining health insurance and pharmacy benefits — like the CVS-Aetna and Cigna-Express Scripts deals, which are now basically completed — is a return to the way things used to be.
The bottom line: Lingering concerns over costs and quality won’t slow down the deal-making. Many other major hospital mergers are pending, more local consolidation is expected, and drug companies are sitting on piles of cash, waiting to spend it on M&A.
What we’re watching: Democratic lawmakers are cracking their knuckles. Rep. David Cicilline (D-R.I.), the incoming chair of the House Judiciary antitrust subcommittee, told Axios he will “launch an investigation into monopoly power in health care markets” this year.
- “We need to examine the impact of hospital acquisitions on costs, quality of care, patient outcomes and the economic opportunity of nurses and other working people in these hospital systems,” Cicilline said in a statement. “Working Americans expect Democrats to deliver on lowering the cost of health care, and failure is not an option.”