Hospital Market Consolidation and Access to Quality Healthcare in New Jersey

In New Jersey (NJ) and across the nation, there has recently been substantial hospital merger and acquisition activity, leading to highly concentrated healthcare markets. While this consolidation can improve hospitals’ financial health and efficiency, it also raises serious concerns about constraining access to needed services and diminishing quality of care, especially among the most vulnerable. Although anti-trust agencies have authority to block harmful consolidations, such action is often limited, and its application varies based on the willingness of the executive branch to intervene or allow markets to function on their own. Moreover, economic theory and prior research suggest that market power arising from health system concentration can lead to widening gaps in access to vital health services and diminished quality of care with special concern for underserved populations including people of color, the uninsured, and Medicaid enrollees. No study has examined whether NJ’s consolidation trend is leading to such outcomes.  

This project will examine whether adverse healthcare access and quality consequences have arisen from hospital market consolidation in NJ.  It will document: 1) trends in NJ hospital market consolidation over 13 or 14 years (2010-2022 or 2023, if available), 2) the association of consolidation with healthcare access and quality, and 3) the extent to which this association exacerbates preexisting disparities in access and quality experienced by vulnerable populations (defined above). Project findings will be disseminated via academic publication and non-technical policy-oriented materials (e.g., blogs, reports) that will be of interest to policymakers, advocates, insurers, journalists, and healthcare providers.