New evidence on the impacts of cross-market hospital mergers on commercial prices and measures of quality

By Daniel R. Arnold, Jaime S. King, Brent D. Fulton, Alexandra D. Montague, Katherine L. Gudiksen, Thomas L. Greaney, Richard M. Scheffler| Published in Health Services Research in April 2024 | Link to full report.

“As hospital systems have expanded, they’ve extended into regions where they previously had no presence. A recent study found 55% of the 1500 hospitals targeted for a merger or acquisition from 2009 to 2019 operated in a commuting zone that the acquirer did not previously operate in. The price and quality effects of these “cross-market” hospital mergers and acquisitions (M&A) are the focus of this paper.”

What this study adds: 

  • Serial acquirers are significant contributors to estimated cross-market price effects.
  • We find no discernible impact of cross-market mergers on mortality and readmission rates for heart failure, heart attacks and pneumonia.
  • Overall, this study provides further evidence that cross-market hospital mergers lead to price increases and novel findings of no quality effect and the impact of serial acquirers on the price effect. More antitrust scrutiny of these mergers—particularly those of serial acquirers—appears prudent given the current state of highly concentrated hospital markets in the United States.

Questions should be addressed to Daniel Arnold,