- Academic medical centers are increasingly merging with nonacademic providers to achieve economies of scale, greater purchasing power and leverage with payers — a move that could put their research missions at risk, a new paper published in JAMA states.
- Nonacademic health systems may lack the infrastructure, management experience and regulatory expertise to support clinical research programs. They also tend to be more focused on the financial bottom line.
- “Importantly, health system administrators may not appreciate the full extent of positive externalities that result from clinical research and as a consequence may expect research to be a profit center,” the authors write.
Today’s teaching hospitals operate in a world of increased expenses, reduced government funding for research and Medicare and Medicaid cuts. This is forcing many to seek economies of scale through partnerships, mergers or acquisition by nonacademic providers.
Up to 20% of the 100-plus annual hospital mergers involving academic medical centers involve nonacademic providers, the authors noted.
While such moves can lead to less focus on clinical research, the outlook isn’t entirely bad. Mergers could bring system-wide adoption of research protocols, expanded patient populations and large databases fed by EHRs, they say. On the other hand, evidence has shown that mergers have led to increased costs pushed down to patients.
To ensure continued support for clinical study programs, potential partners should discuss their vision for research leadership, development of centralized research administrative processes, training needs and a long-term research plan, the authors wrote.
Discussions should highlight the value of clinical research as a source of future referrals, novel treatment options and positive brand building, they add.