Brown University

Delivering Amidst Consolidation: Implications of Hospital Mergers on Newborn and Maternal Outcomes

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Abstract:
As hospital systems consolidate and negotiate higher private health insurance (PHI) reimbursements, the widening difference between PHI and public hospital payments could incentivize hospitals to restrict access to care for lower-margin Medicaid beneficiaries. We examine how hospital mergers affect labor and delivery (L&D) care for mothers covered by Medicaid. Using national Medicaid claims data and US vital statistics data, we find that Medicaid birth admissions decline by an average of 29% following a within-market hospital merger. This reduction is largely attributed to a corresponding 12% decrease in the number of unique L&D providers at merged facilities. Rates of cesarean delivery show modest declines, with no measurable change in induced labor rates. At the county level, newborn health outcomes improve in areas served by hospitals that acquire other facilities. Overall, hospital consolidation appears to reduce access to within-market hospital options while yielding modest improvements in birth outcomes for mothers admitted for L&D care.

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Citation

Hyesung Oh, and Christopher Whaley, "Delivering Amidst Consolidation: Implications of Hospital Mergers on Newborn and Maternal Outcomes" (2025). Center for Advancing Health Policy through Research (CAHPR) Digital Collection. Brown Digital Repository. Brown University Library. https://doi.org/10.2139/ssrn.5804282

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