““Competition takes place on broad service lines, not individual services. Providers offer every possible service, and gear up to handle any patient who walks in the door. Health plans contract with providers across the board. Yet breadth of services per se has little impact on patient value—it is the ability to deliver value in each medical condition that matters. Health plans and providers have merged and consolidated, but the pursuit of breadth and the duplication of services have only increased. As system participants compete on breadth, competition at the medical condition level has been suppressed or eliminated by health plan networks, captive referrals within provider groups, and the almost total absence of relevant information.””
