Do ‘Small-Scale’ Mergers Add Up to Medical Monopolies?

The ongoing growth of the urgent care industry despite naysayers and a challenging payer landscape speaks to the commitment of individual physician owners who recognized the benefit of a different approach to practicing medicine—for themselves and for the patient. As we’ve mentioned here, one recent trend has seen hospital systems gobbling up individually owned urgent care operations. While the government keeps fairly close watch on mega mergers—sometimes blocking them in the interest of protecting an open marketplace—smaller deals like those described above often go unnoticed. A new article published in Health Affairs goes as far as to suggest that as many as 20% of larger practices now owned by hospitals might exceed federal guidelines for market concentration. The authors surmise that many such acquisitions are simply too small scale to raise red flags. Among the startling data points: 22% of markets for primary care doctors, surgeons, cardiologists and other specialties were “highly concentrated” in 2013. According to Federal Trade Commission Guidelines, that means there’s sufficient lack of competition to encourage keeping prices in check. Bells at the FTC only go off when mergers worth $80 or more are on the horizon.