A full-integration merger between two New York City hospitals resulted in better patient outcomes, including lower in-hospital mortality rates, according to a new analysis. The results diverge from prior data showing such deals typically drag down quality.
Hospital consolidations have more than doubled since 2009 and most evidence suggests patients suffer as a result, with takeovers often leading to increased overall mortality and readmission rates along with worse patient experience scores.
But this trend did not play out in NYU Langone Health’s full asset merger in 2016 with Lutheran Medical Center, a 450-bed teaching hospital primarily serving patients on Medicare, Medicaid and the uninsured. The move dropped crude mortality rates, stabilized readmissions, improved safety outcomes and yielded higher hospital rankings.
The authors attributed their success to an “uncommon, value-driven” approach unifying both clinical and administrative governance, they explained Friday in JAMA Network Open.
“Despite evidence that mergers usually reduce quality, we found that strategic consolidations can be associated with substantially improved quality when performed effectively,” Erwin Wang, MD, MHA, and colleagues with NYU Langone Health, added in the analysis.
The study compared 122,348 patients in the pre-merger group (September 2010-August 2016) to nearly 60,000 in the post-merger period (September 2016-August 2019), excluding psychiatric, rehabilitation and newborn patients discharged from the newly named NYU Langone Hospital–Brooklyn.
Wang and co-authors noted a 0.71% absolute (27% relative) reduction in the crude mortality rate and 0.95% absolute (33% relative) drop in the adjusted rate by the end of the 3 year merger period. Readmission rates remained largely unaffected.
Additionally, the merger produced fewer central line infections per 1,000 catheter days and fewer urinary tract infections per 1,000 discharges, the team reported. Patients were also more likely to recommend the hospital or rank it a 9 or higher on a 10-point scale.
Looking back on their strategy, Wang et al. noted NYULH gained minimal market share from the acquisition and received little to no additional negotiating power with payers, unlike most hospital M&A cases.
“The goal of the merger was not revenue-driven; this uncommon full-integration approach was designed and executed to improve quality,” the team underscored.
Read the entire study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.