Kaiser Permanente is often hailed by health reformers as the model other health systems should replicate.

While integrated health systems have the potential to improve patient care, they also encourage hospitals to buy up physician practices to build their own Kaiser Permanente.  This increases provider clout in the marketplace, which has been shown to actually raise healthcare prices for patients:

Despite Kaiser Permanente’s stature as the model integrated health system, it hasn’t been able to substantially lower health costs. And rapid consolidation increases the clout of providers in the marketplace, allowing them to dictate prices. Worse, doctors in such consolidated settings have described pressure to bring in more money, “often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay.”

Therein lies the tension that reformers face, as health reform encourages such provider consolidation by introducing the concept of accountable care organizations.

Read more about my opinion in today’s New York Times Room for Debate: Downsides for Doctors and Patients.

Enjoy the piece.