Forum Session

Health Care Provider Consolidation and Reform
November 13, 2009


Laura A. Dummit


Many blame our fragmented delivery system for high and rising health care spending, so some proposals to address the cost problem have focused on increasing care coordination and improving collaboration among providers. Related payment reforms that reward providers for accepting more financial risk in caring for patients or for meeting the needs of a defined population aim at encouraging care coordination and provider collaboration. To respond to these initiatives, independent providers may find they need to affiliate with larger organizations. Increased provider affiliations, however, raise other concerns about greater consolidation of market power and its effect on quality and prices. This Forum session focused on health care provider consolidation, including efforts to limit provider monopolies, the ramifications of a consolidated provider community, and ways to balance provider and payer interests.


Thomas Greaney, JD, Chester A. Myers Professor and Director, Center for Health Law Studies, School of Law, Saint Louis University; Dianne Kiehl, Executive Director, Business Health Care Group (Milwaukee, Wisconsin); Ruth W. Brinkley, West Ministry Market Leader, Ascension Health, President and Chief Executive Officer, Carondelet Health Network (Tucson, Arizona)

Slides from the presentations by Mr. Greaney, Ms. Kiehl, and Ms. Brinkley are available for download. Speakers' biographies are also available.

Related Materials

See William B. Vogt and Robert Town, “How has hospital consolidation affectedthe price and quality of hospital care?” (Robert Wood Johnson Foundation,Research Synthesis Report No. 9, February 2006).

See also the site visit reports from the Forum's visits to Cincinnati (2004), St. Louis (2007), and Chicago (2008).

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