The integration of hospitals and physicians in the US during the last fifteen years has generated much controversy. We conducted a study to evaluate whether receiving care from hospital-integrated physicians was associated with better care coordination and patient outcomes. We focused on patients’ receipt of cardiac rehabilitation (CR) and likelihood of recurrent cardiac hospitalizations. The study entailed a retrospective cohort of patients based on Medicare Part A and Part B claims data from 2016 to 2019. We followed eligible patients for 12 months after a qualifying cardiac event. We determined physician integration with claims-based place-of-service codes and tax identifiers. Machine learning algorithms were used to identify covariates. The study consisted of 28,596 Medicare patients eligible for CR. Logistic regression via propensity score weighting showed that having a hospital-integrated physician was associated with an 11% increase in the odds of receiving CR [95% CI, 1.05-1.18]. Additionally, CR participation was associated with a 14% decrease in the odds of recurrent cardiovascular-related hospitalizations, 0.86 [0.81, 0.91]. As such, study results indicate that hospital integration has the potential to facilitate care coordination and improve patient outcomes. Further research is needed to understand the specific causal pathways that hospital-physician integration creates for better patient care.
