A Retrospective Analysis of the Clinical Quality Effects of the Acquisition of Highland Park Hospital by Evanston Northwestern Healthcare

Abstract

In 2004, the Federal Trade Commission brought a legal action retrospectively challenging the 2000 acquisition of Highland Park Hospital by Evanston Northwestern Healthcare in Evanston, Illinois. A major issue in that case was whether the merger had resulted in improved clinical quality at Highland Park. In this paper, we describe the conceptual framework that guided our analysis of that issue and we report our findings. Specifically, we examine numerous quantitative measures of clinical quality. We find little evidence that the merger improved quality. We also discuss the applicability of our framework to the prospective analysis of unconsummated hospital mergers.Hospital Mergers, Merger Retrospectives, Antitrust Enforcement, Health Care Quality, I10, L40,

Health Care Markets, Regulators, and Certifiers

“…Using DID methods, Ho and Hamilton (2000) (measuring mortality for heart attacks, strokes, and newborns) and Capps (2005) (using AHRQ quality measures) find little to no effect of hospital mergers on quality. In a case study, the Federal Trade Commission found that the Evanston/Northwestern merger (which it litigated retrospectively) had no impact on quality (Romano and Balan, 2011). Finally, Gaynor et al (2011b) examine the impact of mergers in the United Kingdom.…”

Economics at the FTC: Hospital Mergers, Authorized Generic Drugs, and Consumer Credit Markets

“…For this reason, well-supported claims regarding clinical quality tend to be given more weight than other claims of pro-competitive merger effects. Our methods of evaluating such claims are discussed in detail in Romano and Balan (2011), and so are omitted here in the interest of brevity.…”

Competition in Health Care Markets

“…Third, finding results in every direction isn't terribly surprising with such a large number of different outcome measures. Romano and Balan (2011) is an interesting recent study. Romano and Balan study the impact on quality of care of a consummated merger between two hospitals in the Chicago suburbs (Evanston Northwestern Hospital and Highland Park Hospital).…”