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US business sectors ranging from manufacturing to digital networks have become increasingly concentrated, often yielding fewer choices, poorer service and quality, and higher prices. The business of health care is no exception. Researchers have shown that consolidation of health care entities and services is a key driver of higher prices1 and tends to reduce rather than increase patient satisfaction.2 Consolidation in the pharmaceutical industry stifles innovation3 and increases the vulnerability of the drug supply chain. However, merger announcements continue unabated. For example, in 2019, Optum became the largest employer of physicians following its acquisition of Davita Medical Group, and Catholic Health Initiatives and Dignity Health combined to form a 142-hospital system.
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Corresponding Author: Leemore Dafny, PhD, Harvard Business School and John F. Kennedy School of Government, Harvard University, 15 Harvard Way, Morgan 481, Boston, MA 02163 (email@example.com).
Published Online: January 28, 2021. doi:10.1001/jama.2021.0038
Conflict of Interest Disclosures: Dr Dafny reported receiving personal fees from Bates White Economic Consulting, Cornerstone Research, Analysis Group, and Geisinger Health System and grants and fees from the Brookings Institute, the Arnold Foundation, the Center for Equitable Growth, and the Peterson Center on Healthcare and serving on the board of the Health Care Cost Institute from 2012 to 2020.
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