A doctor at UPMC Hamot hospital in Erie acknowledged recently that one of the main fears of Hamot doctors before their hospital's 2011 merger with UPMC was that the Pittsburgh giant would siphon lots of patients to the big city for care.
That fear has proven unjustified, given statistics that show a 7 percent decrease in Erie County residents leaving the county for treatment.
But that doesn't necessarily mean that trend will continue indefinitely, according to an Erie-based professor experienced in health care issues.
Previously, UPMC was accused of taking a "feed the mother" approach, allegedly sending patients from outlying facilities to its core hospitals in Pittsburgh, according to David Dausey, a public health professor at Mercyhurst University.
But now UPMC is affiliating with hospitals farther away, and to "feed the mother" isn't as easy, he said.
Pittsburgh is too far away from Erie to travel for basic services, if not for specialized ones, and so far, there doesn't seem to be a large number of referrals from Hamot to Pittsburgh, Dausey said.
Pittsburgh is about as far away from Altoona as it is from Erie.
Still, the Hamot affiliation was recent.
"I hate to make statements about this nascent stage," Dausey said. "We need to continue to monitor it over time."
People under sway of "the fierce urgency of now" tend to pay close attention to mergers at first, but the true test will be what is happening five or 10 years from now, he said.
Mergers can be like cable TV deals - enormously attractive at first, then five years later, you look at your bill and find you've been paying way more than you expected, he said.