The Effects of General Practice Mergers on Quality in England

The primary care market has witnessed a growing trend of provider consolidation through mergers and acquisitions, yet the implications of this concentration remain uncertain. This study addresses this gap by providing the first empirical evidence on the effects of provider mergers on quality using evidence from the English primary care market. By analysing all provider mergers from 2014 to 2018, we find predominantly negative effects of mergers on quality. Clinical quality does not change at best, and patient satisfaction decreases dramatically. Notably, the impact on quality varies based on the size of the general practices involved. Mergers between large general practices show a detrimental impact on quality, while mergers between small general practices may yield quality benefits. Additionally, there is no difference in the quality impact between mergers involving parties in the same geographical market and those in different markets. An exploration of the mechanism reveals that mismanagement, rather than changes in market concentration, drives the observed decline in quality following mergers.

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