Higher intensity care for patients with multiple chronic conditions after hospital-physician integration

Introduction Hospital-physician vertical integration—namely, hospitals acquiring physician practices, directly employing physicians, or having significant financial ties to physician practices—has accelerated in recent years. Yet, integration's implications for healthcare delivery for patients with multiple chronic conditions (MCCs) remain poorly understood. Methods This study examined the effect of hospital-physician integration on health services utilization among patients with MCCs using an all-payer claims database. Results We found that hospital-physician integration generally led to higher use of inpatient and ambulatory care, though these findings were heterogeneous across physician specialties and outcomes. Specifically, patients of integrated primary care physicians had more primary care and specialist visits, whereas integration among specialists did not alter the likelihood or frequency of ambulatory visits, highlighting a possible referral-driven mechanism. Conclusion Overall, the integration of hospitals with primary care physicians appeared to intensify non-emergent ambulatory care while also increasing inpatient utilization, raising important questions about whether these patterns represent better care coordination or simply higher service intensity.