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Hospitalist Management Giant Emerges as Sound Physicians, Cogent Healthcare Merge


Sound Physicians' recent acquisition of Cogent Healthcare creates the largest hospitalist management group in the country, which may or may not be a good thing, one hospitalist expert notes.

The deal, which closed last month, creates a company with more than 1,750 hospitalists in 180 hospitals nationwide. Reuters estimated the sale price at more than $375 million.

"We certainly don't care so much about biggest," says Robert Bessler, MD, chief executive officer of Sound Physicians, which will be the merged firms' name moving forward. "We're focused on trying to be the practice of choice for docs and provider of choice for hospitals—and really focus on performance as a business model to drive results."

John Nelson, MD, MHM, a principal in Nelson Flores Hospital Medicine Consultants and regular columnist for The Hospitalist, says he believes the impact of the merger will vary by market.

"Hospitalists in competing groups could benefit, for example, by being seen as a more attractive alternative for candidates in the market to join a practice, and large companies may be able to invest in innovation that might benefit all of us," Dr. Nelson says in an email. "But for others, it may seem to make things worse, for example, by influencing the local market toward lower compensation or higher workload. It will be very market-dependent."

Dr. Bessler says he believes the merger "creates incredible synergy." For example, Cogent has The Intensivist Group, which operates full-service intensivist programs, and it can now potentially expand to hospitals where Sound hospitalists work.

Conversely, Sound’s post-acute-care program can be expanded to hospitals where Cogent has a presence.

Dr. Bessler understands that being the largest group can be seen as a good or a bad thing by industry watchers. "I think it leads to further innovation," he says. "It pools resources to do better things for hospital medicine, for hospitals, for patients, and for docs. And the reality is that even on a combined basis, we have less than 5% of the market. It's a massive market."

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