Press Release

The Impact of Hospital Consolidation on Health Care Affordability in New York State

New CSS analysis finds hospitals charged patients more after mergers, even as hospital costs remained flat

Health care in New York is increasingly unaffordable for patients. Over the past 15 years, hospital charges in New York have increased four times faster than inflation. Hospital spending accounts for more than one-third of total health care spending in the state. Between 2009 and 2024, half (101) of New York's hospitals underwent at least one merger.

A new report from the Community Service Society of New York (CSS), The Impact of Hospital Consolidation on Health Care Affordability in New York State, describes how state policies that encourage hospital consolidation (mergers or acquisitions between hospitals) affect health care costs and charges in New York. It builds on a 2025 report by CSS describing why New York's health care system is so unaffordable. While the 2025 report demonstrated the impact of hospital closures on communities, this report examines the impact on hospital costs and charges. It is the first New York State-specific report to look at the impact of hospital consolidation.

Overall, the report finds that New York State's multi-decade policy encouraging hospital consolidation may have had the unintended consequence of increasing charges for payers and consumers. The report's methodology examined hospital mergers across four regions of New York State and compared hospital charges and costs for three common procedures: appendectomies, vaginal deliveries, and knee replacements.

Key findings from the analysis of state, regional, and procedure-level impacts of hospital consolidation show:

1. Hospital-reported charges increased 1.5 times faster at hospitals that merged, compared to hospitals that did not merge.
2. Hospital consolidation was associated with increased hospital-reported charges and comparatively static hospital-reported costs. Across New York regions, charges at merged hospitals increased 1.3 to 4.5 times faster than costs.
3. Patients needing common procedures, such as appendectomies, deliveries, and knee replacements, at merged hospitals were charged significantly more than patients at non-merged hospitals.

"This report makes clear that hospital consolidation is contributing to the affordability crisis facing New Yorkers. When mergers lead to higher prices without improving care, patients and families pay the price. As Chair of the New York State Senate Health Committee, I believe New York must strengthen oversight, increase transparency, and pursue policies that put affordability and access at the center of our health care system. I thank the Community Service Society for its leadership in identifying practical solutions to help make health care more affordable for all," said State Senator Gustavo Rivera, Chair of the New York State Senate Health Committee.

"As this study shows, hospital charges have grown faster in hospitals that have merged, and this trend has had an outsized impact on access to and affordability of care in rural areas and urban neighborhoods of color," said David R. Jones, President and CEO of CSS. "With the ongoing crisis in health care brought on by the federal H.R. 1 legislation, we call on our state legislators to enact some simple measures to keep hospital charges at merged hospitals in line with costs to protect New Yorkers already burdened by some of the highest health care costs in the nation."

"Hospital charges have continued to outpace inflation, while the costs to hospitals to provide care have remained relatively static," said Mia Wagner, MPA, Director of Health Policy at CSS, report co-author. "New York policymakers should address these skyrocketing charges by considering interventions to cap post-merger price increases."

"This report shows how New York's decades-old push to encourage hospital consolidation has left payers and consumers with an unaffordable health care system," said Elisabeth R. Benjamin, MSPH, JD, Vice President of Health. "It is time for policymakers to fashion meaningful policy responses that will improve health care affordability in our State."

Key Recommendations:

The report calls for a more rigorous policy environment that can curb consolidation-related price increases. Specifically, it identifies three targeted policies to improve transparency and affordability absent transformative policy changes at the national or state level-such as the adoption of Medicare for All or the New York Health Act. Interim policies that could abate merger-related price increases include:

1. Making New York's All-Payer Database publicly available and requiring policymakers to use this data when approving consolidations and setting health insurance premiums
2. Requiring the Public Health and Health Planning Council to establish post-merger caps on price increases when it approves mergers and consolidations
3. Enacting a site-neutral policy, such as the Fair Pricing Act, to control rising charges at hospital outpatient departments.

New York had the second-highest net loss of hospitals in any state between 2001 and 2023. Hospital consolidation and closures are not felt equally across communities. Evidence indicates that consolidation has the greatest impact on rural communities and urban neighborhoods of color, whose already-impeded access to health care services is often disproportionately impacted by post-merger unit closures and price increases. Additionally, studies show that, because of these increased charges, payers and patients pay significantly higher prices for the same services with no apparent improvements to patient care.

This new report was co-authored by Alison Goldberg, Health Policy Analyst for CSS; Mia Wagner, Director of Health Policy at CSS; Zinnia Finn, Health Policy Research Assistant at CSS; and Elisabeth R. Benjamin, Vice President of Health Initiatives at CSS.

Issues Covered

Access to Health Care

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