UPMC and AHN are growing their networks. Is that good?

THE HUMAN BODY IS MADE up of assorted clusters of material. Cells combine to create tissues that can specialize into organs and work together in systems. That’s how we get cardiac tissue making up a heart that drives the cardiovascular system. The health care world can be similar. Doctors and other medical providers have practices that can be affiliated with a hospital that might be part of a health care system. The object of these systems stacked up like Russian nesting dolls is for cooperation and efficiency. There are differences. Your liver doesn’t have to worry about Medicare reimbursement. Your doctor — and your hospital and its system — does. Another? Your skeletal system almost never tries to merge with your digestive system to create a new, larger entity. It can be hard to get a definitive figure for the number of hospital systems in the United States. Definitive Healthcare, a Massachusetts-based company that analyzes industry data, puts the number around 900. The American Hospital Association puts it at 407. The federal Agency for Hospital Research and Quality says it’s 639 as of 2023. But the ebb and flow of mergers, acquisitions, partnerships and networking make that an evolving number. Small systems band together. Larger ones consume independent hospitals. And the giants work the map like a Monopoly board. On Wednesday, UPMC announced it is in talks to take over Trinity Health System in Steubenville, Ohio. Trinity parent CommonSpirit Health is the largest Catholic health system in the country and itself was formed from a merger in 2019. On Thursday, Allegheny Health Network followed with its own announcement of a merger with Heritage Valley Health System. This would add hospitals in Sewickley and Beaver County to the AHN organization, as well as giving the network its first toehold in Ohio with a provider’s office. Hospital mergers can have the same benefits as police regionalization or consolidation of government agencies. It can decrease waste, eliminate duplication of effort and allow for sharing of services and assets. If radiologists are in short supply, for instance, it’s good to have more of them on the payroll across multiple hospitals to share the load. It’s not unlike the cardiovascular system finding its own new pathways to get blood around a blocked vessel. The danger exists with the potential for priorities to become too corporate despite being nonprofit organizations. This is especially true at a time when federal programs — from Medicaid to the Affordable Care Act to research grants — are in flux. This is also especially important given the economic role hospitals and health systems play in Southwestern Pennsylvania, where medicine replaces metal as the dominant industry. A body’s nervous system is necessary to take in information and respond accordingly. A hospital system does the same — but it also needs to focus on its purpose to serve the whole as it grows.