Recent Evidence on Consolidation in U.S. Health Care: Integration Pathways, Impacts, and Implications for Policy, Regulation, and Research

This article synthesizes findings from studies included in a special issue of Medical Care Research and Review ( MCRR) about consolidation in U.S. health care. Articles are grouped thematically, with findings discussed relative to the existing literature on the impact of consolidation on outcomes such as price, expenditures, access, and quality of care delivered. The article highlights key limitations and offers the following suggestions to better inform public policy, regulation, and new payment models: (a) traditional market definitions should be reconsidered given the evolution of consolidation and its impact on the contestability of markets; (b) fair and efficient pricing requires knowledge of production costs, which is currently limited; (c) payment, policy, and regulatory options should better account for the unique challenges in rural markets; (d) state policy change, including examination of existing provider licensing laws, could yield market improvements; and (e) continued investments in data infrastructure are needed to mitigate the potential negative effects of consolidation.