The House Budget Committee convened a hearing on May 23 to examine the budgetary effects of health care consolidation. Dr. Adam Bruggeman from the Texas Spine Care Center testified before the committee and shared his experience in private practice. Dr. Bruggeman highlighted the detrimental impact of health care consolidation on patients and the health care system, arguing that both horizontal and vertical consolidation leads to significantly higher costs for medical procedures without corresponding improvements in patient outcomes.

He cited studies showing that health care services in consolidated markets are about 30-50% more expensive than in competitive ones, noting the resulting impact on affordability and access to care. He identified several drivers of consolidation, including financial pressures stemming from rising operational costs, declining reimbursements, and administrative burden. These challenges are exacerbated by the Medicare Physician Fee Schedule (MPFS), which works to disadvantage independent practices. Dr. Bruggeman called for policy reforms to address these issues, including raising the MPFS budget neutrality threshold, implementing site-neutral payments, and repealing the moratorium on physician-led hospitals. He emphasized that these steps are crucial for preserving competition, enhancing patient care, and ensuring the financial viability of independent practices.