A Road Map for Health Care Consolidation | NEJM Catalyst – nejm.org

September 23, 2022
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This issue of NEJM Catalyst Innovations in Care Delivery contains articles, case studies, and research reports on mergers and acquisitions, behavioral health care in nursing homes, advanced practice providers, telemedicine, fertility care, and maternal health.
Health care is a business. Never is this truth more apparent than when physician practices, hospitals, and entire health systems are bought, sold, and merged — a trend that in the United States dates back 2 decades and shows no sign of slowing. Yet health care is also a public service and even a human right; a source of employment for many and a calling for some; and a highly regulated activity with strict standards for provision and performance. How should health care leaders and clinicians balance these dynamics when approaching mergers and acquisitions?
An article in this issue, “Physician Practice Consolidation: Considerations for the Remaining Independents,” provides an insider view into a recent acquisition. Steven Strongwater, MD, the former president of Atrius Health, a multisite primary and specialty physician practice in Massachusetts, shares his firsthand insights on the motives for merging, the many options, and a process that other organizations can use in their own decision-making.
Health care is a business. Never is this truth more apparent than when physician practices, hospitals, and entire health systems are bought, sold, and merged…. Yet health care is also a public service and even a human right; a source of employment for many and a calling for some; and a highly regulated activity with strict standards for provision and performance. How should health care leaders and clinicians balance these dynamics?
Other articles and case studies in this issue of NEJM Catalyst Innovations in Care Delivery address a wide range of current concerns in health care. “Scaling Supply to Meet Behavioral Health Demand in New York State Nursing Homes” by Adam C. Simning, MD, PhD, and associates details how University of Rochester Medical Center has used a combination of telehealth, on-site visits, and staff education to improve nursing home residents’ access to behavioral health services. “Promoting Professional Fulfillment for Advanced Practice Providers” by Monica Nandwani, DNP, RN, FNP-BC, and associates relates how Stanford Health Care, recognizing the increasingly important role in care delivery of advanced practice providers (APPs) such as nurse practitioners and physician assistants, has intentionally sought to improve their professional fulfillment, decrease burnout, and improve retention.
In “Busting Three Myths About the Impact of Telemedicine Parity,” Kathleen Fear, PhD, and colleagues recount their study of telemedicine visits at University of Rochester Medical Center. They find that contrary to widespread assumptions, telemedicine closed care gaps for vulnerable patient populations without lowering the quality or increasing the cost of care. “The Fast Track to Fertility Program: Rapid Cycle Innovation to Redesign Fertility Care” by Suneeta Senapati, MD, MSCE, and colleagues describes Penn Medicine’s use of APPs, telemedicine, and an artificial intelligence–driven platform to accelerate diagnostic workups and access to care for patients with infertility.
This issue’s Insights Report, “Abortion Restrictions Add to Challenges of Maternal Health Care” with Emily Scibetta, MD, of Ventura County Medical Center and Chloe Zera, MD, MPH, of Beth Israel Deaconess Medical Center is based on a survey of NEJM Catalyst Insights Council members at organizations worldwide directly involved in care delivery. In the related Insights Interview, Council members from the United States and Argentina comment on the impact that government restrictions on abortion are likely to have on maternal health care.
We invite our audience to contribute their solutions to the big problems facing health care today, by submitting articles, joining the Insights Council, and participating in our virtual events.
Edward Prewitt is Editorial Director for NEJM Catalyst, Namita Seth Mohta is Executive Editor, and Lisa Gordon is Managing Editor. Thomas H. Lee is CMO of Press Ganey, Editor-in-Chief of NEJM Catalyst Innovations in Care Delivery, and Co-Chair of the NEJM Catalyst Editorial Board.
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The October 2022 issue of NEJM Catalyst Innovations in Care Delivery offers insider views and innovative practices to address the problems of health care.
The former president of Atrius Health, which was acquired by Optum Care, shares insights into the landscape for physician practice acquisition and the variations based on the types of organizations involved.
How nurse and physician shortages will change care delivery and how health care can evolve to meet this challenge.

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