ArticleHealth services research2020
Health system integration with physician specialties varies across markets and system types.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Community Characteristics Associated With Health System Penetration.Medical care research and review : MCRR · 2026Article
- Health System Integration and Prior Authorization in Medicare Advantage.Health services research · 2026Article
- Transitions Within and Use of Outpatient Primary and Oncology Care in Survivors of Adolescent and Young Adult-Onset Cancers.JCO oncology practice · 2026Article
- Market strategies used by private hospital providers to consolidate and increase power; a systematic scoping review and evaluative synthesis.Globalization and health · 2026Article
- Increases In Physician Professional Fees In Private Equity-Owned Gastroenterology Practices.Health affairs (Project Hope) · 2025Article
- How do hospitals exert market power? Evidence from health systems and commercial health plan prices.Health affairs scholar · 2025Article
- Qualitative perspectives of Medicaid-insured patients on ambulatory care at an academic medical center: challenges and opportunities.BMC health services research · 2024Article
- Assessing the Impact of the 340B Drug Pricing Program: A Scoping Review of the Empirical, Peer-Reviewed Literature.The Milbank quarterly · 2024Article
- Hospital outpatient department billing is a poor indicator of primary care practice integration with hospital systems.Health services research · 2024Article
- The Mayo Leadership Impact Index Adapted for Matrix Leadership Structures: Initial Validity Evidence.Journal of healthcare leadership · 2024Article
- Within-Physician Differences in Patient Sharing Between Primary Care Physicians and Cardiologists Who Treat White and Black Patients With Heart Disease.Journal of the American Heart Association · 2023Article
- Examining the National Representativeness of the Axon Registry: A Neurology-Specific Patient Registry.Neurology · 2023Article
- Vertical integration in oncology: what does it mean for patients with cancer?Journal of the National Cancer Institute · 2023Article
- How Type of Practice Ownership Affects Participation with Quality Improvement External Facilitation: Findings from EvidenceNOW.Journal of general internal medicine · 2022Article
- Health system integration with physician specialties varies across markets and system types.Health services research · 2020Article
- Making integration work.Health services research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine system integration with physician specialties across markets and the association between local system characteristics and their patterns of physician integration. DATA SOURCES: Data come from the AHRQ Compendium of US Health Systems and IQVIA OneKey database. STUDY
designWe examined the change from 2016 to 2018 in the percentage of physicians in systems, focusing on primary care and the 10 most numerous nonhospital-based specialties across the 382 metropolitan statistical areas (MSAs) in the US. We also categorized systems by ownership, mission, and payment program participation and examined how those characteristics were related to their patterns of physician integration in 2018. DATA COLLECTION/EXTRACTION
methodsWe examined local healthcare markets (MSAs) and the hospitals and physicians that are part of integrated systems that operate in these markets. We characterized markets by hospital and insurer concentration and systems by type of ownership and by whether they have an academic medical center (AMC), a 340B hospital, or accountable care organization. PRINCIPAL
findingsBetween 2016 and 2018, system participation increased for primary care and the 10 other physician specialties we examined. In 2018, physicians in specialties associated with lucrative hospital services were the most commonly integrated with systems including hematology-oncology (57%), cardiology (55%), and general surgery (44%); however, rates varied substantially across markets. For most specialties, high market concentration by insurers and hospital-systems was associated with lower rates of physician integration. In addition, systems with AMCs and publicly owned systems more commonly affiliated with specialties unrelated to the physicians' potential contribution to hospital revenue, and investor-owned systems demonstrated more limited physician integration.
conclusionsVariation in physician integration across markets and system characteristics reflects physician and systems' motivations. These integration strategies are associated with the financial interests of systems and other strategic goals (eg, medical education, and serving low-income populations).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.