JAMA study finds nonprofit hospitals spent $7.8B on management consulting over 2010-2022 with no statistically significant improvements in finances, staffing, operations, or patient outcomes.
Key Takeaways
Researchers used IRS Form 990 filings and machine learning to identify consulting contracts, comparing 306 hospitals that hired consultants against matched controls.
No meaningful changes found across net patient revenue, operating margin, days of cash on hand, readmission rates, or mortality; only a small uptick in stroke readmissions.
Over 20% of nonprofit hospitals engaged management consultants during the study period; average spend was $15.7M per hospital.
When HR and IT consultants are included, total nonprofit hospital consulting spend exceeds $25B over the same period.
Authors call for greater transparency in how tax-subsidized nonprofit hospitals allocate consulting dollars, and more research before drawing causal conclusions.
Hacker News Comment Review
Commenters split on the “blame-shifting” theory: one argued consulting spend lets hospital bureaucrats deflect accountability for unpopular decisions, but another pushed back that these management consultants are not advising on high-level strategic calls.
Thin discussion overall; no technical methodological critique of the JAMA study’s matched-control design or IRS 990 data limitations surfaced.
Notable Comments
@boznz: argues consulting spend functions as political cover, letting administrators distance themselves from unpopular policies.
