Consolidation among care providers is not
good news for patients. It often results in fewer choices, higher prices, and
potentially worse care. But provisions in the Patient Protection and Affordable
Care Act (PPACA), also known as ObamaCare, have accelerated mergers and
acquisitions of physician practices.
UNC Health Care System and its subsidiary Rex Healthcare recently created Triangle
Physician Network with 15 practices and 60 doctors. This network will
likely expand to encompass more doctors as the hospital system looks for more
ways to self-refer and doctors look for greater security in larger
organizations. WakeMed and Duke University Health System are also creating
their own networks.
The law authorized a new provider structure called the accountable care
organization (ACO). Mergers had already begun as physicians sought protection
from new Medicare rules that could create global payment plans for providers.
But the new law gave more impetus to this trend. Hospitals are acquiring
physician networks, and physicians are merging smaller practices into larger
practices. The federal Department of Health and Human Services is looking to ease
enforcement of fraud and abuse laws so ACOs can operate more freely.
More doctors are looking to get out of the insurance business altogether and
move to a direct pay model.
