With the recent announcement that pharmacy giant CVS is buying Aetna in a multibillion-dollar health insurance/pharmacy services merger, the consolidation of the healthcare industry has taken a giant step in a direction that can be characterized as both forward and backward, depending on your perspective. Doubtless, the landscape is changing for consumers and healthcare providers alike.
Consolidation happens
Patients and healthcare providers throughout the United States have long been caught in the middle of hospital acquisitions and mergers. Many smaller community hospitals have been swallowed up by larger hospital systems, and such changes bring both benefits and drawbacks for all parties concerned.
Home health and outpatient hospice have also seen consolidation, with larger players owning increasing chunks of market share. The rapid aging of the population fuels some of these fires, as does the economic realities of healthcare reform, potential repeal of aspects of the Affordable Care Act and other factors.
While CVS purchasing Aetna won't necessarily impact nurses and other healthcare professionals immediately, it's still a signal that change is afoot as regulators consider giving such an enormous merger the green light.
Advocates say that a consolidation like the CVS/Aetna deal will create local healthcare hubs for patients seeking comprehensive outpatient medical attention. Others say corralling patients into narrow markets with limited choices will decrease quality of care and patient satisfaction.
What about jobs?
If certain CVS locations become more akin to community health centers, some nursing jobs may indeed be created.
Triage, nursing assessments, diabetes and chronic disease management, vaccination clinics and other services could be venues for registered nurses and nurse practitioners to work in novel community-based environments. Whether these (as yet nonexistent) jobs will deliver competitive salaries and benefits remains to be seen.
In various American healthcare job markets, consolidated health systems can be a mixed employment bag for nurse job seekers. In some cities, two or three competing hospital systems can control a vast majority of hospitals and outpatient sites, thus nurses can be faced with fewer choices of employers as the market narrows.
A narrower employment market translates to increased difficulty finding work with less corporately-beholden healthcare entities. And where there are fewer employers to compete with one another, it's feasible that salaries for nurses and other staff won't necessarily see an appreciable increase.
Finally, if CVS siphons off an increasing number of Americans from hospitals and emergency rooms for urgent care, bloodwork and other healthcare services, there could be a loss of valuable and well-paying hospital jobs, including nursing positions.
Consolidation and conjecture
If approved, the merger between CVS and Aetna would be enormous in terms of its projected impact on the American healthcare system. In terms of its effect on consumers, the jury is still out. And regarding the impact on nurses and other healthcare employees, we still live in the land of conjecture and educated guesses.
As in many industries, competition for employees and consumers is generally seen as healthy for everyone. And we must note that historically significant corporate mergers don't always benefit the workers or the marketplace.
In terms of the further consolidation of the healthcare system, nurses and their healthcare colleagues will need to read the writing on the wall and assess the repercussions of such changes to the employment landscape. If salaries and benefits stagnate or quality of care suffers, nurses can choose to leverage their position as the largest body of healthcare professionals in pursuit of more compensation for their expertise.
As for consumers, only time will tell if the rosy predictions for such megamergers will prove correct, or if it's only the corporations who will truly prosper.
