Speculating About the Impact of Healthcare Industry Consolidation on Long-Term Services and Supports
Marshall B. Kapp, J.D., M.P.H*
Many aspects of the healthcare industry in the United States today are caught up in a vigorous “get big or get out”1 trend characterized by significant consolidation of healthcare providers and insurers. 2 The current health industry consolidation movement promises to exert an important and powerful array of effects on numerous different population groups seeking or receiving health services in a variety of different healthcare settings. The other articles in the present Symposium issue of the Annals of Health Law address several of those groups and settings. Particularly regarding the potential impact of health industry consolidation on individuals contemplating, seeking, or obtaining long-term services and supports (LTSS), little is known but much may be plausibly speculated. This article joins in that speculation, but attempts to advance the constructive consideration of the topic by offering some suggestions for a research agenda to investigate specific empirical questions about consolidation’s impact on LTSS and thereby generate evidence and knowledge that can be used to either reduce or prevent negative aspects of consolidation for LTSS, on one hand, or foster and facilitate the achievement of positive effects, on the other. For purposes of the present analysis, LTSS (the modern term that largely has replaced the earlier, more narrowly construed term “long-term care”) 3 refers to ongoing individualized assistance with activities of daily living
Director, Florida State University Center for Innovative Collaboration in Medicine and Law and Professor, FSU College of Medicine and FSU College of Law. 1. William A. Brandt, Jr. & Andrew M. Troop, Health Care Financing Trends: What Do They Foreshadow?, 33 AM. BANKR. INST. J. 18, 19 (2014). 2. See generally Bara Vaida & Alexander Wess, Health Care Consolidation, ALLIANCE
FOR HEALTH REFORM (Nov. 2015), http://www.allhealth.org/publications/Consolidation- Toolkit_169.pdf. 3. This change in nomenclature is reflected in both academic literature and government programs. See, e.g., Long-Term Services & Supports, CTRS. FOR MEDICARE & MEDICAID SERVS., http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long- Term-Services-and-Supports/ Long-Term-Services-and-Supports.html (last visited Apr. 13, 2016).