1) HHS Releases New Data and Report on Hospital and Nursing Home Ownership
Today, the Department of Health and Human Services (HHS) is taking actions to promote competition and transparency in our nation’s health care system that can improve the safety and quality of nursing homes and hospitals. The Centers for Medicare & Medicaid Services (CMS) is releasing data publicly -- for the first time -- on mergers, acquisitions, consolidations, and changes of ownership from 2016-2022 for hospitals and nursing homes enrolled in Medicare. This data is a powerful new tool for researchers, state and federal enforcement agencies, and the public to better understand the impacts of consolidation on health care prices and quality of care.
HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) is also releasing a related report — an analysis of the new CMS data examining trends in changes of ownership over the past six years.
These new data and analysis support President Joe Biden’s Executive Order on Promoting Competition, and advance the Biden-Harris Administration’s goal of improving transparency around nursing facility ownership and enhancing nursing home safety and quality, as outlined in President Biden’s State of the Union Action Plan for Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes.
“Today, for the first time, we are releasing data on the impact of hospital and nursing home consolidation for people across our nation. By improving the quality of reporting by hospitals and nursing homes on ownership and consolidation, we also advance President Biden’s agenda to promote competition, lower health care costs for American families, and protect patients,” said HHS Secretary Xavier Becerra.
“Hospital and nursing facility consolidation leaves many underserved areas with inadequate or more expensive health care options,” said CMS Administrator Chiquita Brooks-LaSure. “This new data gives researchers, state and federal enforcement agencies, and the public new opportunities to examine how mergers, acquisitions, consolidations, and changes of ownership impact access to care, care quality, and prices as a way to enable greater transparency and insight into the hospital and nursing home industries.”
CMS’s data on the changes of ownership — which includes details on mergers, acquisitions, and consolidations — is now available on data.cms.gov. The data can help researchers, enforcers, and the public analyze trends and issues in health care markets, and more specifically, provide insight into how the ownership of health care providers impacts costs and outcomes of consumers. For example, ASPE’s report identifies several findings from the new dataset:
Changes of ownership have been much more common in nursing homes than hospitals over the past six years.
There is also wide ownership variation by state. For instance, 19% of hospitals (14 out of 73) in South Carolina were sold during this period, while most states had fewer than 4% of hospitals change ownership.
A majority (62.3%) of Skilled Nursing Facilities (SNFs)that were purchased have a single organizational owner, 6.9% have multiple organizations owners, while 18.2% have only individual owners and 12.7% have both types of owners.
CMS expects to release updated change of ownership data on a quarterly basis. The CMS data will enhance transparency for hospitals and nursing homes patients, potential patients and their loved ones, as well as for policymakers and the communities where these facilities are located.
2) Hospital Change of Ownership
The Hospital Change of Ownership (CHOW) dataset provides information on the hospital ownership changes that occurred on or after January 1, 2016. This data includes information on the buyer and seller organization’s legal business name, provider type, change of ownership type (CHOW, Acquisition/Merger, or Consolidation) and the effective date of the change. This data is gathered from the hospital change of ownership information maintained in the Provider Enrollment, Chain, and Ownership System (PECOS).
3) Skilled Nursing Facility Change of Ownership
The Skilled Nursing Facility (SNF) Change of Ownership (CHOW) dataset provides information on the SNF ownership changes that occurred on or after January 1, 2016. This data includes information on the buyer and seller organization’s legal business name, provider type, change of ownership type (CHOW, Acquisition/Merger, or Consolidation) and the effective date of the change. This data is gathered from the SNF change of ownership information maintained in the Provider Enrollment, Chain, and Ownership System (PECOS).
4) Changes in Ownership of Hospital and Skilled Nursing Facilities: An Analysis of Newly-Released CMS Data
This report analyzes newly-released data from CMS that provides information on changes in ownership among hospitals and skilled nursing facilities (SNFs), based on information reported to CMS through the Provider Enrollment, Chain, and Ownership System (PECOS). Analyses of this dataset demonstrate 347 changes in ownership among hospitals and more than 3000 among skilled nursing facilities between 2016 and 2021, with wide variation across states. Ownership changes were more common in medium and larger hospitals (compared to small hospitals), hospitals with low profit margins (compared to more profitable hospitals), and long-term care hospitals. Future research can link this new dataset to other sources of information to support policymaking and research on consolidation, health care quality, and health care costs.