TRAUTWEIN

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more than 6% when one merges with or acquires another in the same geographic region. Some experts put the average price increase at nearly 20%.

Findings like these are intuitive. Why would hospitals and health systems share their cost savings with patients and insurers? When they buy up their competition, they don’t have to worry about losing customers. There’s nowhere else for them to go. That gives them leverage to demand higher prices from payers.

And that leads to higher premiums. Between 2014 and 2017, enrollees in the Affordable Care Act’s exchanges who lived in areas with higher levels of hospital concentration had annual premiums 5% higher than those in less concentrated areas.

Those increased costs don’t buy better care. Research in the New England Journal of Medicine concluded that “hospital acquisition by another hospital or hospital system was associated with modestly worse patient experiences and no significant changes in readmission or mortality rates.”

There’s some evidence that consolidation actually yields worse care. Medicare patients living in highly concentrated hospital markets are nearly 5% more likely to die within one year of having a heart attack than those living in less concentrated markets.

And despite conglomerates’ claims, mergers don’t typically lead to an expansion of services or save hospitals from closing. In many cases, health systems concentrate services in a regional “hub” hospital — and transform smaller hospitals into little more than outpatient clinics.

Despite all these downsides, federal antitrust regulators haven’t done much to stop healthcare merger mania. The FTC has attempted to block just 1% of hospital mergers over the past few decades.

It’s long past time for that to change. The FTC’s hospital merger guidelines haven’t been updated since 2010. And according to reporting from ProPublica, they only detail how to evaluate and challenge consolidation between hospitals in the same market.

There’s nothing on how to deal with hospitals buying up competitors in other markets.

Consolidation among healthcare providers is far from what the doctor ordered. Lawmakers and regulators need to put a stop to it.

Janet Trautwein is CEO of the National Association of Bene-fits and Insurance Professionals ( nabip. org).