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A softer form of health care consolidation, where independent primary care practices align in certain Medicare accountable care organizations (ACOs) to negotiate with payers, may lead to higher prices, but not to an overwhelming extent, according to a new study published Monday in Health Affairs.
Researchers focused their work on independent practices joining ACOs led by health systems as allowed under the Medicare Shared Savings Program (MSSP). With these arrangements, there are no outright mergers or acquisitions, but the authors said not much is known about the extent to which arrangements lead to price increases.
To that end, the researchers used claims and enrollment data from a large national commercial insurer that included negotiated payment rates with independent practices from 2010 to 2016, and created a model that simulated what would happen when health systems and providers began working together, hypothesizing “that joint negotiation with health systems would raise nonsystem practices’ prices substantially and abruptly.”