"But whatever the purported efficiencies of vertical integration may be, these deals should be seen as part of a larger corporate transformation that is remaking American healthcare – for the worse.
"Consider corporate medicine's track record. Dialysis is dominated by corporations – the two largest are DaVita and Fresenius – that do a comparatively poor job keeping their patients alive. A 2011 study in Health Services Research found that for-profit chains had 13% higher risk of mortality than not-for-profits. DaVita, meanwhile, has paid out hundreds of millions in recent years to settle claims including Medicare fraud and overuse of a potentially harmful medication."
"But whatever their financial future, the advancing corporatization of American healthcare will fail for a more fundamental reason: cutthroat corporate profiteering and the humane provision of healthcare don't mix."
Editor's note: How does US nephrology respond to being named the poster child of bad corporate medicine? They've gone full-ostrich. They eliminated any reporting on the effects of profit/non-profit clinic ownership from the annual United States Renal Data System (USRDS) report. This results in a '3-monkey' approach to medicine and is probably best summed up by Sinclair Lewis.
Perhaps these companies will finally pursue the business opportunity that would benefit their patients and society most: renal re/habilitation. They should work to prevent renal disease, optimize the lives of those with renal disease and renal failure, and bring business efficiencies to renal disease spending.
What organization is doing this already? DCI, the largest non-profit dialysis provider. And what organization has had the best mortality and hospitalization rates for 14 consecutive years (until they stopped reporting this data)?
What will Fresenius and DaVita likely do with the money? Buy back stock, pay off and restructure debt, and
offer larger incentives to US nephrologists to join their for-profit model of care.
"“This is about your zip code, not your gene code,” ACP President Jack Ende, MD, said during the society’s annual conference, held this year in New Orleans. “Where a person is born and what the social determinants of health are for them can have very, very significant outcomes on health.”