The Impact of Ambulatory Acquisitions on the Cost of Business
DOI:
https://doi.org/10.33423/jabe.v27i1.7499Keywords:
business, economics, acquisitions, healthcare, health insuranceAbstract
This study contributes to the literature regarding the increase in acquisition activity and the annual increase in the cost of health insurance premiums for small to middle size businesses. Th research specifically addressed the HCPCS billing rates of procedures before and after acquisition; it examined the annual increase in the percentage of ambulatory physicians compared to the increase percentage in health insurance premiums, and the increase in health insurance premiums was evaluated based on age, type of firm, and size of the firm. The results indicated a statistically significant difference in the billing rates of procedures before and after ambulatory acquisition.
References
Baker, J.J., Baker, R.W., & Dworkin, N.R. (2018). Health care finance (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Becker, T.E., Atinc, G., Breaugh, J.A., Carlson, K.D., Edwards, J.R., & Spector, P.E. (2016). Statistical control in correlational studies: 10 essential recommendations for organizational researchers. Journal of Organizational Behavior, 37(2), 157–167. http://dx.doi.org/10.1002/job.2053
Blocher, E.J., Stout, D.E., Juras, P.E., & Smith, S.D. (2019). Cost management: A strategic emphasis (8th ed.). New York, NY: McGraw-Hill Education.
Bloomfield, J., & Fisher, M.J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses' Association, 22(2), 27–30. http://dx.doi.org/https://doi.org/10.33235/jarna.22.2.27-30
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The Affordable Care Act at 5 years. New England Journal of Medicine, 372(25), 2451–2458. http://dx.doi.org/doi:10.1056/NEJMhpr1503614
Brookstone, A. (2012, February 5). The impact of EHRs on productivity: Physicians share experiences [Blog post]. Retrieved from http://www.americanehr.com/blog/2012/02/impact-of-ehr-on-productivityproductivity/
Camilleri, S. (2018). The ACA Medicaid expansion, disproportionate share hospitals, and uncompensated care. Health Services Research, 53(3), 1562–1580. http://dx.doi.org.ezproxy.liberty.edu/10.1111/1475-6773.12702
Capps, C., Dranove, D., & Ody, C. (2018). The effect of hospital acquisitions of physician practices on prices and spending. Journal of Health Economics, 59, 139–152. http://dx.doi.org/10.1016/j.jhealeco.2018.04.001
Carlin, C.S., Feldman, R., & Dowd, B. (2016). The impact of hospital acquisition of physician practices on referral patterns. Health Economics, 25(4), 439–454. http://dx.doi.org.ezproxy.liberty.edu/10.1002/hec.3160
Chapman, L.W., Ferris, K., & Zachary, C. (2017). Utilizing break-even analysis in a competitive laser market. Wiley Periodicals Inc., pp. 10–11. https://doi.org/10.1002/lsm.22753
Chernew, M., Cutler, D.M., & Keenan, P.S. (2005). Increasing health insurance costs and the decline in insurance coverage. Health Services Research, 404(4), 1021–1039. http://dx.doi.org/doi:10.1111/j.1475-6773.2005.00409.x
Cleverley, W.O., & Cleverley, J.O. (2018). Essentials of Health Care Finance (8th ed.). Burlington, MA: Jones & Bartlett Learning.
Cowley, D. (2004). HIPAA: One year later. Public Relations Strategist, 10(2), 18–20. http://ezproxy.liberty.edu/login?url=https://search-proquestcom.ezproxy.liberty.edu/docview/204920992?accountid=12085
Creswell, J.W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Thousand Oaks, CA: Sage.
Creswell, J.W., & Poth, C.N. (2018). Qualitative inquiry & research design. Choosing among five approaches (4th ed.). Thousand Oaks, CA: Sage Publications, Inc.
Cuellar, A.E., & Gertler, P.J. (2003). Trends in hospital consolidation: The formation of local systems. Health Affairs, 22(6), 77–87. http://dx.doi.org/10.1377/hlthaff.22.6.77
D'Arrigo, T. (2019, July 2). HHS adjusts penalties for HIPAA violations. Psychiatry News. http://dx.doi.org/https://doi.org/10.1176/appi.pn.2019.6b11
Dauda, S. (2017, May 11). Hospital and health insurance markets concentration and inpatient hospital transaction prices in the U.S. health care market. Health Services Research, 53(2), 1203–1226. http://dx.doi.org/10.1111/1475-6773.12706
David, F.R., & David, F.R. (2017). Strategic management: A competitive advantage approach (16th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.
Dennis Jr., W.J. (2016, October 31). A new healthcare longitudinal survey by the NFIB Research Foundation 2013. NFIB Research Foundation. Retrieved from https://www.nfib.com/surveys/aca-2013/.
Depew, B., & Bailey, J. (2015). Did the Affordable Care Act's dependent coverage mandate increase premiums? Journal of Health Economics, 41, 1–14. http://dx.doi.org/https://doi.org/10.1016/j.jhealeco.2015.01.004
Fifer, R. (2016). Health care economics: The real source of reimbursement problems. American Speech-Language-Hearing Association. Retrieved from https://www.asha.org/Articles/Health-Care-Economics-The-Real-Source-of-Reimbursement-Problems/
French, M.T., Homer, J., Gumus, G., & Hickling, L. (2016). Key provisions of the Patient Protection and Affordable Care Act (ACA): A systematic review and presentation of early research findings. Health Services Research, 51(5), 1735–1771. http://dx.doi.org/https://doi.org/10.1111/1475-6773.12511
Greaney, T.L., & Ross, D. (2016). Navigating through the fog of vertical merger law: A guide to counseling hospital-physician consolidation under the Clayton Act. Washington Law Review, 91(1), 199–251. Retrieved from http://ezproxy.liberty.edu/login?url=https: //search-proquest-com.ezproxy.liberty.edu/docview/1790602538?accountid=12085
Guerin-Calvert, M.E. (2014). Competitive effects analyses of hospital mergers: Are we keeping pace with dynamic healthcare markets? The Antitrust Bulletin, 59(3), 505–513. http://dx.doi.org/doi:10.1177/0003603X1405900304
HCPCS - General information. (2019). Retrieved from https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index
Hecker, L.L., & Edwards, A.B. (2014). The impact of HIPAA and HITECH: New standards for confidentiality, security, and documentation for marriage and family therapists. The American Journal of Family Therapy, 42(2), 95–113. http://dx.doi.org/ https://doi.org/10.1080/01926187.2013.792711
Himmelstein, D.U., & Woodhandler, S. (2016). The current and projected taxpayer shares of US health costs. American Journal of Public Health, 106(3), pp. 449–452. http://dx.doi.org/10.2105/AJPH.2015.302997
HIPAA Journal. (2019). HIPAA explained. HIPAA Journal. Retrieved from https://www.hipaajournal.com/hipaa-explained/
Howard, D.H., David, G., & Hockenberry, J. (2017). Selective hearing: Physician-ownership and physicians’ response to new evidence. Journal of Economics & Management Strategy, 26(1), 152–168. http://dx.doi.org/https://doi.orgezproxy.liberty.edu/10.1111/jems.12178
Jacobe, D. (2013). Half of U. S. small businesses think health law bad for them. Retrieved from https://news.gallup.com/poll/162386/half-small-businesses-think-health-law-bad.aspx
Kaiser Family Foundation. (2020). Professionally Active Physicians [Data file]. Retrieved from https://www.kff.org/
Kirkwood, J.B. (2016). Buyer power and healthcare prices. Washington Law Review, 91(1), 253–293. Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquestcom.ezproxy.liberty.edu/docview/1790603454?accountid=12085
Lahm Jr., R.J. (2014). Small business and Obamacare: The new law's rules do apply to the vast majority of all businesses. Entrepreneurial Executive, 19, 131–147. Retrieved from https://link.gale.com/apps/doc/A397579784/ITOF?u=vic_liberty&sid=ITOF&xid=19b4f752
Lifetime & Annual Limits. (2017). Retrieved from https://www.hhs.gov/healthcare/about-theaca/benefit-limits/index.html
Mayer, S., Kiss, N., Laszewska, A., & Simon, J. (2017, August 14). Costing evidence for health care decision-making in Austria: A systematic review. PLOS ONE, 12(8), 1–18. http://dx.doi.org/https://doi.org/10.1371/journal.pone.0183116
McCue, M.J. (2015). Hospital acquisitions before healthcare reform. Journal of Healthcare Management, 60(3), 186–196. Retrieved from http://ezproxy.liberty.edu/login?url =https://search-proquest-com.ezproxy.liberty.edu/docview/1685997011?accountid=12085
McCue, M.J., Thompson, J.M., & Kim, T.H. (2015, May 1). Hospital acquisitions before healthcare reform. Journal of Healthcare Management, 60(3), 186–204. Retrieved from https://link-gale-com.ezproxy.liberty.edu/apps/doc/A417471587/AONE?u=vic _liberty&sid=AONE&xid=d72bd0a5
McIntyre, G. (2020). What is the definition of small business? Retrieved from https://www.fundera.com/blog/sba-definition-of-small-business
Mihaylova, T., Dimitrov, T., Gradinarova, N., & Todorova, D. (2018). Characteristics of human resource planning in healthcare. Journal of IMAB, 24(1), 1953–1956. http://dx.doi.org/https://doi.org/10.5272/jimab.2018241.1953
Mobley, L.R. (1997). Multihospital chain acquisitions and competition in local health care markets. Review of Industrial Organization, 12, 185–202. http://dx.doi.org/https://doiorg.ezproxy.liberty.edu/10.1023/A:1007747713353
Morgan, G.A., Leech, N.L., Gloeckner, G.W., & Barrett, K.C. (2013). IBM SPSS for introductory statistics: Use and interpretation (5th ed.). New York, NY: Routledge.
Queiros, A., Faria, D., & Almeida, F. (2017). Strengths and limitations of qualitative and quantitative research methods. European Journal of Education Studies, 3(9), 369–387. http://dx.doi.org/doi: 10.5281/zenodo.887089
Rees, C., Alfes, K., & Gatenby, M. (2013, February 14). Employee voice and engagement: connections and consequences. The International Journal of Human Resource Management, 24(14), 2780–2798. https://doi.org/10.1080/09585192.2013.763843
Reschovsky, J.D. (2015). Hospital Acquisition of Physician Groups: On the Road to Value-Based or Higher-Priced Care? JAMA Internal Medicine, 175(12), 1939–1941. http://dx.doi.org/10.1001/jamainternmed.2015.6183
Robson, C., & McCartan, K. (2016). Real world research (4th ed.). Hoboken, NJ: John Wiley & Sons.
Schenker, J.D., & Rumrill Jr., P.D. (2004). Causal-comparative research designs. Perspectives on Scientific Inquiry, 21(3), 117–121. Retrieved from https://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00260
Thompson, A.A., Peteraf, M.A., Gamble, J.E., & Strickland III, A.J. (2018). Crafting & executing strategy: The quest for competitive advantage (21st ed.). New York, NY: McGraw-Hill Education.
Woodlock, P. (2014, January 1). Obamacare: Impact on business combinations. The Journal of Corporate Accounting & Finance, 25(2), 19–26. http://dx.doi.org/10.1002/jcaf.21918
Yang, S. (2014, October 21). Hospital mergers and acquisitions leading to increased patient costs. Mind & Body, Research. Retrieved from https://news.berkeley.edu/2014/10/21/hospital-mergers-acquisitions-patient-costs/
Yin, R.K. (2018). Case study research and applications design and methods (6th ed.). Sage.
