Transforming Health Care Through Evidence and Collaboration
Transforming Health Care Through Evidence and Collaboration
The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to improving the effectiveness, efficiency and quality of America's health care system.
  • Advisory Board

    NIHCM Foundation is pleased to welcome Dr. Scott Gottlieb, Sherry Glied, PhD, and Katherine Baicker, PhD, to its distinguished Advisory Board. Their ideas and insights will advance NIHCM's mission to improve health care for millions of Americans.

    Press Release Advisory Board
  • Awards

    NIHCM Foundation hosted the 25th Annual NIHCM Awards at the Organization of American States in Washington, D.C. to recognize outstanding health care research and journalism.

    Press Release Winners Finalists
  • News

    NIHCM welcomed Secretary Azar to a meeting in March to discuss efforts by the Department of Health and Human Services to transform health care by lowering costs and improving value for patients.

  • Webinars

    As recognition of our country's mental and behavioral health challenges grows, Americans are looking for answers that will increase their happiness and well-being and prevent deaths of despair related to mental health, opioids and suicide. Our four-part webinar series delves into the research and explores innovative strategies and evidence-based solutions to lift our society from crisis.

    Learn More
  • Grants

    NIHCM Foundation has awarded ten grants for health care journalism including investigative reporting, public engagement campaigns for documentaries and educational opportunities for reporters.

    Press Release All Journalism Grantees Apply for Funding
  • Grants

    NIHCM has awarded over $400,000 in grants to support seven investigator-initiated research studies on topics including value-based drug pricing and Medicaid expansion.

    Press Release All Research Grantees Apply for Funding
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

Events

June 13, 2019
opioids-2019-webinar-graphic

The final part in our four-part Defying Despair series, this webinar discussed ongoing efforts to increase access to evidence-based treatment for opioid use disorder and guide people on a path to recovery.

May 16, 2019
Alliance-Rx-Patent-Webinar-052019

Manufacturer practices under the current patent system have come under scrutiny for blocking or delaying the entry of generic or biosimilar drugs into the market. During this webinar, panelists explored the relationship between patents, prices and patient access.

In the News

July 2019
Population Health Spotlight
ALZ-panel1-June2019

How Are Health Care Prices Related to Physician Practice Consolidation and Integration with Hospitals?

Why These Studies Are Important

Health care providers of all types are rapidly consolidating to form larger organizations. An extensive body of research has demonstrated that hospital consolidation is associated with significantly higher prices for hospital services, with little beneficial impact on quality of care. NIHCM grantee Dr. Laurence Baker and colleagues have extended this provider consolidation research by looking at the price effects of the growing vertical integration between hospitals and physician practices and of the ongoing consolidation of physician practices into larger and larger group practices. Four papers have been published to date from this work.

What The Studies Found

  • An increase in the market share of hospitals owning physician practices was associated with higher hospital prices and higher spending for privately insured patients.1
  • Depending on the specialty, the prices paid by private PPOs for office visits were 8 to 16 percent higher in counties with the highest concentration among physician practices than in those on the lower end of the spectrum. Markets that began the study period with less competition among practices also experienced larger price increases over the next 8 years.2
  • Private prices for a range of common surgical and medical procedures were 8 to 26 percent higher in counties with the least competition among physician practices, relative to the counties with high levels of competition.3
  • Increases in the degree of concentration of orthopedic practices over the 2001-2010 period were associated with an increase of about 7 percent in the prices paid by private insurers for total knee arthroscopy, largely offsetting the secular decline in physician fees occurring over the period absent changes in market concentration.4

What These Findings Mean

  • Individually, and collectively, these studies add to the literature raising concerns about growing provider consolidation.
  • Unchecked consolidation by providers can confer appreciable market power that results in higher prices.

More About The Studies

These studies used multiple years of commercial health care claims spanning U.S. markets and examined county-level or other market variation in provider integration measures and private prices. Full details on methods can be found in the articles cited below.

Full Citations

1. Baker LC, Bundorf MK, and Kessler DP. “Vertical Integration: Hospital Ownership of Physician Practices is Associated with Higher Prices and Spending,” Health Affairs, 33(5):756-63, 2014.
2. Baker LC, Bundorf MK, Royalty AB, and Levin Z. “Physician Practice Competition and Prices Paid by Private Insurers for Office Visits,” The Journal of the American Medical Association, 312(16):1653-62, 2014.
3. Austin DR and Baker LC. “Less Physician Practice Competition Is Associated With Higher Prices Paid for Common Procedures,” Health Affairs, 34(10):1753-60, 2015.
4. Sun E and Baker LC. “Concentration In Orthopedic Markets Was Associated With A 7 Percent Increase In Physician Fees For Total Knee Replacements,” Health Affairs, 34(6):916-21, 2015.

For more information about these studies, contact Dr. Laurence Baker at laurence.baker[at]stanford.edu.
For more information about the NIHCM Foundation Investigator-Initiated Research Grant Program, contact Dr. Julie Schoenman at 202-296-4426.

Read More

Dr. Laurence Baker and his colleagues, with support from NIHCM research grants, have produced a series of papers examining the relationship between provider market power and private prices in a variety of scenarios. This Research Insights highlights the key takeaways from four published papers.

Events

June 13, 2019
opioids-2019-webinar-graphic

The final part in our four-part Defying Despair series, this webinar discussed ongoing efforts to increase access to evidence-based treatment for opioid use disorder and guide people on a path to recovery.

May 16, 2019
Alliance-Rx-Patent-Webinar-052019

Manufacturer practices under the current patent system have come under scrutiny for blocking or delaying the entry of generic or biosimilar drugs into the market. During this webinar, panelists explored the relationship between patents, prices and patient access.

In the News

July 2019
Population Health Spotlight
ALZ-panel1-June2019

Grants

Journalism GrantsJournalism Grant Program

We are now accepting letters of inquiry for the 2019-2020 round of grantmaking. The deadline for submissions is July 15, 2019.

Read More


NYTUpshotLogo

Investigator-Initiated Research Grant Program

We are no longer accepting letters of inquiry for the 2019-2020 round of grantmaking. A small number of applicants will be invited to submit a full proposal in September.

Read More

Awards

Winners Named in the 25th Annual Research and Journalism Awards

Winners Announcment 2018 1

Congratulations to all of the winners of the 25th Annual NIHCM Foundation Research and Journalism Awards! The winners and finalists were honored at a banquet in Washington, DC, in May.

Read More