Integrated Health Services are frequently thought as a tool to decrease healthcare-related costs, specially in systems with a high level of fragmentation. In the US healthcare system reform, Medicare has often been used as a reference point of the overall health expenditure. In this post, this hypothesis is analysed according to a recent article from the National Bureau of Economic Research ("The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured") where the authors review the costs of 306 Hospital Referral Regions in the US, showing a big discordance between Medicare costs and overall costs.

In the analysis of Josh Freeman it is said that the dominant position of some integrated health services in some regions is used to perform very efficient healthcare provission in the Medicare level but also to increase the rates to private insurers.

The post concludes that integrating health systems could help to control healthcare costs by means of sharing data, not repeating tests and improving patients experience and safety as they can be assisted in the most clinically appropriate setting; on the other hand, this potential savings would not be properly achieved if providers are allowed to use their dominant position in the healthcare market to raise prices to insurers, which would be finally passed on to beneficiaries. Nevertheless, the main idea the author remarks is that a health system is good when patients' benefits are prioritised over insurers or providers interests.  

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Medicine and Social Justice