The June issue of Health Affairs focused heavily on health system consolidation and its relationship to opportunities or failures in the marketplace. Surprisingly, the articles in the issue failed to accurately present the role that consolidation plays regarding independent physicians' practices and how the survival of these practices can help provide the same services less expensively than with consolidation. In concentrated markets after mergers or acquisitions of independent medical practices, prices can increase by up to 40 percent. This can create an anticompetitive market that favors consolidated hospital systems, leaving independent facilities with minimal leverage to negotiate reasonable reimbursement rates. Thus, patients are likely to pay more for a given procedure in a large health care system than they would in an independent setting. Furthermore, patients' choice of providers is limited.
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