Hospital Mergers, Hospital Choice, and Care Quality for Pregnant Enrollees in Medicaid

This cross-sectional study of labor and delivery admissions among patients with Medicaid found that hospital mergers were associated with an increased probability of admission to safety-net hospitals, lower probability of NICU-equipped hospitals, and worsening in 1 obstetric quality metric. These changes differed for Medicaid vs commercially insured patients and varied among Medicaid patients in urban vs rural markets. The findings underscore the importance of considering local market structure and potential adverse impacts on low-income populations when evaluating proposed hospital mergers.