Will Health Systems Own Healthcare?

In all of my many conversations this past week, there was an underlying understanding that health systems are getting bigger and bigger. The trends of hospitals acquiring other hospitals is having a major impact on healthcare. Hospitals acquiring ambulatory clinics is probably having an even bigger impact.

As I ponder on this trend, I really can’t imagine a way that we return to the previous status quo. Certainly some doctors will tire of being employed by health systems, but I’m sad to say that once they’re ready to leave they may not find many doors available for them to take.

Aside from a limited number of direct primary care doctors in affluent areas, I believe it’s going to become extremely difficult for a doctor to leave a health system. In some areas, this is already the case. However, value based reimbursement is going to make this an impossibility for many.

I don’t think we know all the unintended consequences of this change in healthcare. As a capitalist, I love economies of scale and you can see how healthcare could benefit from some of these economies. However, what isn’t clear to me is that health systems do a great job capitalizing on economies of scale. In fact, I bet if you studied it you’d probably find that small physician practices run much cheaper than a large health system. If someone knows of a study that looks at this, I’d love to see it.

I do think that some specialists are bonding together in some areas to create super groups in order to combat this trend. In many ways they essentially create a monopoly of sorts around a certain specialty physician service in a local area. I’ll be interested to see how this plays out. Might be a short term win, but I’m not sure they can survive long term.

I’m still chewing on all the ways that we’ll benefit and suffer in a health system owned healthcare system. I’d love to hear your thoughts in the comments on these trends and the impact for good and bad of these changes.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.