Many of you have probably heard a lot about the mergers or acquisitions of hospitals. You may have even been an unwilling victim of these actions.

Smaller rural hospitals are closing or being gobbled up by larger hospital organizations. There seems to be in some states, a provider that has a huge majority of the market share, leaving patients with less choice.

The carnage is more heavily felt by patients who live in rural areas or areas that had less access to healthcare historically. Finding specialty cancer care has always been a challenge now it is becoming even more difficult to access care that is even further geographically away.

As with many areas of healthcare, the most affected are people of color, and those who are already socially and economically challenged, consequently restricting patients to care while increasing healthcare spending. 

Physician practices are being caught up in market-share grab. Many oncologists and hematologists are no longer private entities, they are now owned by hospitals and cancer centers.  

In fact, the market power that hospitals have been welding has been relatively unchecked resulting in fewer physicians owning their own practices. This trend is more noticeable in the field of oncology. From 2008 to 2018, 658 community-based oncology practices were acquired by hospitals, another 432 shut their doors completely. 

The landscape has changed significantly over the past 25 years. Hospital mergers have reduced the number of hospitals from about 8000 to 6000, and only 47% of physicians worked in private practice in 2022, down from 60% in 2012. The real numbers are still out as for the 2023 year end.

Documented allegations are that hospitals and health systems nationwide are using their growing market power to engage in anti-competitive behavior, including the practice of steering patients to certain providers. This behavior erodes competition among hospitals and providers, which manipulates vendors into an all-or-nothing agreement.

Be aware of what's happening in your area.

If you are receiving care, find out if something is changing and if it is or has, how is the change going to affect your ability to see your specialist, get second opinions, and importantly, if the cost of your treatment or visits to providers are going to increase.

You may find yourself having to go out-of-network to continue treatments with your provider or switch plans.

This can be difficult if you’re out of the enrollment period, and could be a problem for both medicare beneficiaries as well as private health insurance members who may find their premiums increasing.

Don’t expect a notification to come to you in the mail. If contracts are being worked out between healthcare systems before the acquisition is completed you may be stuck influx. 

For cancer patients who don’t have the luxury of delaying care, this uncertainty can be very disruptive if they find themselves having to switch providers in the middle of treatment. The additional physical, emotional, and mental stress can be overwhelming and can lead to worse health outcomes. 

As the last few years have taught us, the healthcare arena is constantly changing. Thankfully, there has been some progress in terms of Medicare out-of-pocket costs, a push to reduce expensive drugs, and the ACA, but be aware that new and more complicated barriers could rear their ugly heads.

Being hyper-aware of what’s going on with your care providers, your insurance as well as your treatment plan and its cost, is even more important than ever before. Be proactive in your myeloma care!