Despite the continuing US hospital merger wave, it remains unclear how mergers change, or fail to change, hospital behavior and performance. We open the black box of hospital practices through a megamerger between two for-profit chains. Benchmarking the merger's effects against the acquirer's stated aims, we show they achieved some of their goals, harmonizing electronic medical records and sending managers to target hospitals. Postacquisition managerial processes were similar across the merged chain. However, these interventions failed to drive detectable gains in performance. Our findings demonstrate the importance of organizations for merger research in health care and the economy more generally.

Martin Gaynor, Adam Sacarny, Raffaella Sadun, Chad Syverson and Shruthi Venkatesh

1 January 2026

Review of Economics and Statistics 108(1) , pp.272?281, 2026

DOI: 10.1162/rest_a_01384

https://direct.mit.edu/rest/article/108/1/272/117900/The-Anatomy-of-a-Hospital-System-Merger-The

This work is published under POID and the CEP's Growth programme.