Distribution of Charity Care, Commercial, & Medicaid Payer Mix Following Hospital Mergers

Abstract

Hospital mergers are becoming increasingly common across the current U.S healthcare market. Advocates in support of hospital mergers argue that they promote continuity of care and help to contain healthcare costs. In contrast, a heavily concentrated market may increase hospital prices and lead to a reduction in the number of services provided. This analysis examines the change of hospital payer mix following hospital mergers which occurred from 2016-2021. Utilizing a generalized linear model, it was observed that for-profit hospitals that merged had a significant increase in care provided to charity care payer mix patients (p <.005). Nonprofit hospitals had a significant increase in the provision of care to Medicaid payer mix following a merger (p < .024) and a decrease in the provision of care to commercial payers (p<.005). The changes captured across payer mix by hospital ownership may signal a response by health insurance providers or regulatory entities to the changing landscape brought on by a hospital merger.