Hospital mergers don’t improve quality: Study

With health systems now controlling the majority of U.S. hospital beds, mergers often promise better care. However, a paper published in September 2025 in Social Science & Medicine by University of Pennsylvania researchers Mark Pauly, PhD, and Lawton Burns, PhD, found the claims do not hold up.

The paper, obtained by Becker’s, analyzed three decades of research records. It found that hospital mergers frequently raise prices while failing to improve patient care quality.

“The quality defense for a merger is not supported by theory or evidence,” the researchers said in a news release. “The only sure thing is that a merger will result in higher prices for the merged hospitals, not improved quality. We argue that this non-result is to be expected, since a firm that gains more pricing power through a merger will not find it profitable to improve quality at the same time, even if it could.”

The paper reviewed research on mortality rates, complication rates and patient satisfaction scores. It found no evidence of improvement following mergers, with a quality decline in certain instances. 

The study also found several reasons for why larger systems don’t always provide better care. Merged hospitals don’t always consolidate their medical staff or reduce care sites, which can prevent the volume-based learning that could improve outcomes. They also don’t regularly enhance work conditions or increase nurse staffing ratios.

“Here is some advice: No. 1, treat nonprofit mergers the same as for-profit mergers,” Dr. Pauly and Dr. Burns said in the release. “There is no evidence that ownership form makes a difference for hospitals; No. 2, say ‘no’ to horizontal mergers that reduce competition in local markets; and No. 3, if you must approve a merger, make it conditional on improvement in quality goals or the merger will be unwound.”

The post Hospital mergers don’t improve quality: Study appeared first on Becker’s Hospital Review | Healthcare News & Analysis.