Dr Robert Nesse Examines Consumer Reactions to Consolidation

Robert Nesse, MD, the senior director of Policy and Payment Reform at Mayo Clinic, discussed the impact of healthcare consolidation for consumers, whether or not they are aware of it, and how the government will respond to this consolidation.

Transcript (modified)

What are consumer reactions to consolidation in healthcare? Do they know it’s happening? Do they know why it’s happening?

I don’t belive they’re thinking about the megastructures of what’s going on in healthcare, but it can impact them very immediately, and that would be if their provider has changed, their employment status or somebody else’s has changed, the insurance model can change, and then that patient can no longer go to that provider or, at least, not until they change their insurance. Then it’s immediate. And the patient can’t put that into some larger context so that hits immediately.

Another thing I think can happen is as these models change very quickly, benefits models change, too. People that are used to one set of benefits can end up in trouble unless they read carefully the fine print, if you will, of the insurance model going forward—even the bold print of the insurance model going forward—in order to make the transition.

In 2015 there were a number of large healthcare mergers announced. Do you think we’ll start to see the government cracking down on these mergers?

It depends on how they turn out. So remember that while we might have all heard about 50 insurance company mergers, 500 medical groups merged and were acquired last year, in 2015. This is being done not just for market power, there are forces that really the government would like in terms of coordinated care, population health models, more advanced analytics, meaningful use of electronic medical records—all of those require groups to get bigger.

So you really can’t say we want a model in which people require or need integrated care to be successful both in the provider viewpoint and a patient viewpoint, and then say we can’t support the structure that allows that. So I don’t think they’ll be stopped, I think they’ll be heavily regulated and that’s probably appropriate.