Washington Post: Debate Over Whether Big Health Systems Help Cut Costs

In Roanoke, Va., one company owns the city's two hospitals and six others in a region of 250,000 residents, commanding the area's largest economic engine and a workforce that includes 550 doctors, The Washington Post reports. Carilion Clinic's consolidation has sparked a local row: Is this the future of integrated, efficient health care delivery, or is it a gilded-age style monopoly?

"Carilion says it represents an ideal envisioned by the nation's new health-care law: a network that increases efficiency by bringing more doctors and hospitals onto one team, integrating care from the doctor's office to the operating room. The name for such networks, which the new law strongly promotes with pilot programs, is accountable care organizations." But, critics warn that the level of consolidation Carilion represents can dive up medical spending by stifling competition. Doctors outside the system say the hospital is using its broad network to keep patients in-house, and last year federal regulators forced it to sell an imaging center, because its purchase of the center had driven up prices (MacGillis, 8/16).