Consolidated health care hurts New York patients

Hospitals are snapping up physician practices. Between 2019 and 2022, they acquired nearly 5,000 of them. More than half of doctors nationwide now work for hospitals and health systems.

My colleagues and I do not want to capitulate to such hospital-driven consolidation, and we’re confident our patients don’t want more care driven into the hospital setting. To stay independent, we’ve teamed up with something called a management services organization, which gives us financial and operational support to provide better, higher-value care while preserving our autonomy in how we care for our patients.

Unfortunately, our model is under threat. MSOs are often backed by private equity firms. That’s led to calls to bar independent practices from partnering with MSOs, arguing that the arrangement prioritizes returns for investors over the interests of patients.

That has not been the case for my independent oncology practice, including my office in Patchogue — or hundreds of other independent practices nationwide. Independent practices provide care as good or better than that provided by practices affiliated with hospitals — and at lower cost.

The health care market is complicated. Physicians spend more time on tasks that have little to do with practicing medicine — negotiating with insurers, recruiting doctors, staying up to date on the latest medical records technology. Selling to a hospital may seem like a straightforward way to offload tasks like these and focus on providing care to patients.

But physicians who become hospital employees sacrifice their independence. Their new employer might second-guess every decision they make.

Partnering with an MSO, by contrast, can let physicians delegate nonmedical concerns without losing the freedom to practice medicine with the best interests of patients in mind. It also can give independent practices access to the financial resources they need to serve more patients — and invest in the cutting-edge care they seek.

My practice has opened clinics in historically underserved communities — most recently, in Brooklyn and in Queens. These moves were made possible by capital provided by our private equity-backed MSO partner OneOncology. Our MSO has also helped us recruit top-notch physicians — 62 in the past year — and further expand access to care.

Partnering with an MSO allows us to connect patients to clinical resources typically only available at large health systems and academic medical centers. For example, our MSO has provided more than 2,000 cancer patients access to more than 700 clinical trials, letting them receive promising experimental treatments in their home communities where our clinics are located, rather than traveling long distances to urban medical centers.

Patients and the health care system benefit when independent practices are viable alternatives. Our practice is the lowest-cost oncology provider across the markets we serve and the sole major cancer care provider in the metropolitan area that accepts all insurance plans, including Medicaid. And we’re not an outlier. According to a Harvard Medical School analysis, hospital-based care is nearly 30% more expensive than care delivered at an independent practice.

I’ve seen firsthand how partnering with a private-equity backed MSO can improve patient care. That’s what makes the attacks on the model so confounding.

As in any sector of the economy, there are bad actors. But barring independent practices from affiliating with MSOs out of general antipathy toward private equity would prevent millions of patients from choosing to receive high-quality, lower-cost care from groups like mine.

This guest essay reflects the views of Dr. David Eagle, a board-certified hematologist-oncologist at New York Cancer & Blood Specialists and vice president of the American Independent Medical Practice Association.