医院整合的政策解决方案（英）

   AEIPolicy Solutions for HospitalConsolidationBy 3nenj. Mile and Jesse iMi. EhrenfeldNoemoer 2022Key Poinls :ssiro" go k:3.ir ir thP<: Ican s: vi:es s'u is s* :Xr:+ . a *calth an* oet no pnvn. r 51 xrceit c nolicmal lo:lth t cxonli c, 90 t* of ctr: itim slotis.i:al (nos (m s, Cen: rso id; k:l f;r Fcs>it: vitc:s. ar:5s :xn:t : mr:>o itan st3. sti:sl a a an+ ors :en: tr:k: i:le:l hro. slierlly ,.- Fcost msursh "g doueei I, m, <: Toooit: consol-ie. c, ir < rlirg h g"cnt$ Eer st vites. * * isuran >+miums ar': o:r's, "<rrl shanir. k :I uali.:Qir s, :nl rlecrcmeits the a:l c. xxience.- Fc: cymak: > w mu lipl: ls : r ri* :*ti,nuel <n'>romcil, mediy slingl cay-e+e : *+>,, ,,*+:, , * :++ (:'e+ l c' r *ul,' , s.lv w.?witi1 rver S178 hillion1 in thc Coollavi13 Ai..fuinds.: 'rle Clevcland clinic: snrchascd : i-an-Relcr, nd Rennrmie Sec (tiaR, Ae tindcialk isr:sscc: I1nspiral From rhc Siar:rs nf vlcnrd: serisncd n healrl1 care 2rmiders ovcr tlic nesEFlr:- Sstem in ih: clinie's hom: ()'-in markct ilTn year3, rccen: cr:ncern '-as fnesed on howI>cceihcr 2.3.:- and oncd a riarc he3[ical iine:mh:n: ad orcen wcll-Icsoured he:lri1 svs-Iodon in wa.Teim3 c. cp r:ved snverilmcnt tunling. I:xmpl arcIn this concxr, [olieymakcrs lac apopri-n:mers, irl ih: rianeially st:hle: tlevclaid3.cl lcgun r :1estinn rhc m:rkcr. s* r:thealil<linic nccivin2 GiAR1:SN Acr tinda while re[>rri*gcarc sysrrms in cr:nsolic ated merkcrs. whi c manyIcrd oz1 oxratin inr:r1c c1ring rhe: :aldeme.IccenT li tfrITs e: frxucd n >sriinwich ovcer S12 'sil1:nn i- lcng-Tcrm incscmelrsdrug nr'ccs, * calch cre scvicc rc[prese:*r a signif-and casy acecas rn dehr tineneing cecn during rhcicant parrion nf rhc: nat'nn's healrlh rarc: cx[x:ndi-hcighr cf rlc andcmic, witl : 6isc: milliol1 crcdirTurca, with hias pital care: Ireprcacning 3o.8 percenlil1 nd S: m:1licn in inescmeilr ir1c, rhcr 1.1 rrilio1 annual'y, h:lc 3[e:*ding rn plysi-c levrlaid t inic: wa? wcl [sirionad no wcarher aisn 3ric has Ichcd g.ni perer of nrirhalmulriycar financial rorm. Ix:sp r: [ande:rlic Fian-cxpenr:renrneroohillirnnn:alk.ncial s3cs, rhc: orgaizario1 ld ne 9niNicr [:rcen nf rcrprl'ran seariarical arca?duc rn rreeiving ovrr $3s2 milion i+ t A Rs Acr[E,s, X I ()A;v.ERIC.AN 三NTERPRI3三 IN:TIT_TE cm[:loyces throngh rising ccdurrih'c, co-gays,markcrs :s definrd hv rhc reral 1 iadc (:nmis-3ion (II:) :*d Ixpart.ncn nf.Imst'x (12I) Anri-and eoinsnranec: ratcs. The: nckersnrk is nor rhc1 'l I>ix Isir:n guiceline-. 1u, hnsr1:al xmn id:acmly erea where cnrtane1s :are h..ri: I zrly eviclenceI rn i a rerx n sulsjer rf pl'cy nerer, wth I+3ugest* :hai.higher heal: can: cnsis can indi recrlyI." nax: nmmirx:c: n T1 ,I:dicii Nxoms uputut rr3 ssulitm1lee rn ( cmjeli: icm Pnl ry, A-i.rusl, ane. C irn-"rising c>ls.umer Righis hr:lding a cz1 hearing rn haspitalAs [xil: of a nar.ral market nexme, healihcrnsnlidarirn.: Yer hrs>iral msrkers arr nrt rhr onlypians Tirrarc and narrr minagec. earc nezsrrka Tocrsm[:cnen n" rare c.e very ihal ia cr:nsrs:lalert.lwer ci>al and. Jre4erve n in[:rove nuali y." ThisAmbnl:rory markels : e alan cr:nsolic.ated, wirh anrecnces [xrie ni chnx in alreacy conxolidared eare.csT'marrd 32 [X IccnT of MSA3 s' milarly crns ideRcddclivery msrkers. while: quali:y ga'na :and ayamcrsnsolil:alerd Ror jrinaly enre [phyaici:**:ani s ipl-ngineer'ng are nllen :.srl j..lil, his-sial nelcen fr sjerialry csre." na s e sThe cxer: sr n"hnspital marker prwr is nr: jusA rer[ective r:y fhopiral mrgers: : sing mul-: srhalally cuesiart in ilirprly f'ecis crsnsume rs.In'e il:si aaae4 crr:ssing heal:h sysi em civ: fershi>I>uring 2s02 rale negol iaions, Mainellecl:h, : he'ihanid jurali [e Tormence d:i:a c.enclet. no imlove-3y3re: n orx Iaring in a highly cr:ncrn:rated mar'se:,ments in courersme-me: nre:d qualiry afre: merge 1s.ire mla ia ilae: najor *e:'th insurer I-levanc?These were ile rme:1lry rnmmn mea nles aeh a(fi>lerly An:hen) 1.ia1 1 wi::l:1 wi:hcraw laie30-cay lea:lniainrt raes rr 3:d:y moraily. InRiekl n:er in Pit an: frm helh lanfaer, rherr was a mre.esr dee:ine: in [xxic ni exgri-nei xirk," ancl ihe ( 1.c1 gpnne:1 :n "-xl alu:ul iih:p meiries.'*in ihe loral pe[e1.+ Wil ih>usan:Is of ixmun'er?while 1lafirinnal me2autes c' o4l and cuelityIenri:1ly fac ing rmf-rf-crwork ch:arges des[>ireTren:l n :he: wrrng :dirert'n+ fr:I Mrsumera, iherethe hnsjital exhilrti'g :a ple-anclemic: ce ali*gare anlcdlition:l mening lul ail.ri h:arms. New: 1:i:armaigirt cf nealiy 1: jelxem* or isur 1imes ihe irid:slin inereal in 1:'nl mrk1 com1ilion i+ anI mr an,' :he crnraring disjute ws e:*n-c merging lens throng hiech x examine hnspiral:all: "si>lveil, :1l:e 1 v i: 1he 1erm f 1hp c>nraiconse*' dalicn, wih mony healih rr:fesairn:ls-rpe[, uuealinel:.rding hys r:ians, nursrs, ane. sharmar:isis faeBerause of intreas ing Ineal anc: narion:a' fnen?ing mr:n>pisony rwer when ihey enter l:l:cr mal-(in Pnsjrial crnsislitaian, in Ihis re[orl we teviexkels i- rxinan il:nil rpgion4. Ileal:h sysms win*ihe harns nt' *nsr