Analysis of Rural Hospital Mergers and Impact on Services: A Health Affairs Study

The Impact of Hospital Mergers on Rural Healthcare Services

A recent analysis published in Health Affairs has shed light on the effects of hospital mergers on rural healthcare services, particularly in the areas of maternal, neonatal, surgical, and mental health care. The study, conducted by researchers from IBM Watson Health and the Agency for Healthcare Research and Quality, found that recently acquired rural hospitals were more likely to shut down maternal, neonatal, and surgical care services compared to those that remained independent.

According to the study, mental health and substance use disorder stays remained stable at the catchment areas of acquired rural hospitals, while those discharges increased for rural facilities that had not been acquired. This discrepancy could indicate an unmet need for these services across the merged hospitals’ broader communities.

Rachel Mosher Henke, senior director at IBM Watson Health, expressed concerns about the trade-offs associated with hospital mergers. While mergers may help keep rural hospitals financially afloat, they could also result in hospitals that are less responsive to community needs.

The researchers identified 172 rural hospitals that merged between 2009 and 2016 and compared them with 549 independent hospitals. The analysis revealed that merged hospitals were less likely to be critical access hospitals, had more beds, were more often privately owned, and were more frequently located in the South.

The study found that the average number of hospital stays decreased across maternal/neonatal and surgical service lines for both merged and independent hospitals following a merger, with greater declines observed among the merged facilities. However, mental health and substance use stays remained steady across merged hospitals but increased in comparison hospitals.

The researchers also analyzed catchment area use to determine whether individuals were receiving unoffered services elsewhere in the community. While access to inpatient care did not significantly decline post-merger, there was a notable increase in mental health and substance use disorder stays in comparison hospitals’ catchment areas.

Overall, the findings suggest that hospital mergers may have mixed effects on rural healthcare services. While some hospitals may benefit from increased resources and best practices, others may experience a reduction in essential services that are vital to their communities. As the debate over provider consolidation continues, it is crucial to consider the potential impacts on patient care and access to essential healthcare services.