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Chasing efficiency in theory is excellent, but in action, the outputs don’t always reflect the goals. My research team and I are seeing this firsthand in certain healthcare settings. The U.S. healthcare system has been moving for years to consolidate independent practices. Hospitals are swallowing them up, which should mean better communication, more efficient patient care, and lower costs. But that doesn’t seem to be the case according to some of our research findings, which for the purposes of a recent study published by Management Science [1, 2], we focused on the world of gastroenterology. Our research has shown that this fast-growing trend, which falls under the general umbrella known as vertical integration – the creation of strategic combinations of healthcare alliances meant to enhance the delivery of healthcare – is actually hurting patients in various ways. The most concerning of which is related to the quality of care they receive.