Do mergers really reduce costs? Evidence from hospitals

In this paper, we compare potential and realized cost savings from hospital mergers. Our approach isolates changes in realized cost savings due to different output mixes from systematic changes due to time and also provides a measure of the potential cost savings due to scale economies. Our findings suggest that economies of scale are present for merging hospitals and they realize these cost savings immediately following a merger. However, we also show that over time, cost savings from the merger decrease and the proportion of hospitals experiencing positive cost savings declines.

A difficult metamorphosis: the incorporation of the Ross Institute & Hospital for Tropical Diseases into the London School of Hygiene and Tropical Medicine

Images

The evolution of a contemporary academic health care system

The story I wish to tell today is of the emergence, over the last two centuries, of an integrated academic health care delivery system from the foundations of this country's fourth medical school, New Hampshire's first major hospital, and a multidisciplinary practice group, unique in its time. I will trace the covergence of each of these into a system that we offer as an answer to the contemporary puzzle of how to provide the best available care at value and still support the academic missions of education and research. We believe this to be the current delemma of American medicine, and while our answer may not be either successful or universally applicable, we are committed to the attempt. As background, let me provide some perhaps familiar details of the growth of these Hanover [NH] and Lebanon [NH] institutions.