The Source’s Katherine L. Gudiksen co-authors report on health care market oversight
Bruce Allain, Managing Editor January 29, 2024
The Milbank Memorial Fund has published a report titled “Models for Enhanced Health Care Market Oversight — State Attorneys General, Health Departments, and Independent Oversight Entities” authored by Erin C. Fuse Brown and The Source’s own Katherine L. Gudiksen. The report looks at tools state policymakers are using to address harmful health care market consolidation, focusing on how states have expanded the review authority of the Attorney General (or other state agencies), and have given authority to review transactions to additional oversight entities. The authors reviewed applicable state statutes and …
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Governor Newsom’s Healthcare Budget Proposal for 2024-25
Dilani Logan, Student Fellow January 22, 2024
On January 10, 2024, Governor Gavin Newsom released his proposed California state budget for 2024-2025. In a year where the state was expected to struggle financially, the Legislative Analyst’s Office had originally predicted that the budget deficit could extend upwards of $68 billion due to 2023’s seven month tax filing extension, steep stock market declines, and economic dampening from the Federal Reserve’s interest rate hikes. However, to the surprise of many, the released budget projected a significantly smaller budgetary shortfall at $38 billon. The Governor announced plans to close this …
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North Carolina Attorney General Files Suit Against HCA Subsequent to 2018 Hospital Purchase
Bruce Allain, Managing Editor January 16, 2024
On December 14, 2023, the North Carolina Attorney General (AG) filed suit against HCA Healthcare, Inc. alleging that HCA violated the Asset Purchase Agreement (APA) it signed when it acquired Mission Health System. HCA is the largest for-profit hospital chain in the United States and in 2018, it acquired Mission Health System, which serves western North Carolina. At the time of the merger, the North Carolina AG required the signing of an APA that included assurances that HCA was committed to continuing certain critical services (including emergency, trauma care, and …
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The Source Roundup: January 2024 Edition
Dilani Logan, Student Fellow January 2, 2024
Healthcare Costs and Spending Arriving at a Fair Price in the Medicare Drug Price Negotiation Program: Considerations from Other Countries (Health Affairs Forefront) John K. Lin, James I. Barnes, Jalpa A. Doshi, Salah Ghabri, Peter Kolominksy-Rabas, Brian O’Rourke The Centers for Medicare and Medicaid Services (CMS) are slated to begin negotiating drug prices for a subset of Medicare drugs soon, due to the Inflation Reduction Act (IRA) of 2022. Recognizing the subjectivity involved in determining fair drug prices, this article highlights the authors’ perspectives on CMS’ current strategic shortcomings and analyzes …
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United Health Subsidiary Optum Sued for Anticompetitive Practices in Federal Lawsuit
Bruce Allain, Managing Editor December 15, 2023
Research indicates that concentrating control of healthcare providers and facilities into a handful of massive health systems leads to higher healthcare costs, without improving quality of care. There are often limited possibilities available for smaller marketplace participants who are attempting to compete with the giants in the field, especially when the giants engage in unfair business practices. On November 20, 2023, Emanate Health filed an antitrust with the US District Court for the Central District of California. The complaint alleges that Optum engaged in unfair and unlawful business practices and …
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Recapping the 2023 California Legislative Session (Part 2): Healthcare Services and Pharmaceutical Costs
Dilani Logan, Student Fellow December 14, 2023
In the last issue of California Legislative Beat, we examined some significant bills from year one of California’s 2023-2024 legislative term. Specifically, we focused on legislation that sought to make changes in healthcare competition, consolidation, and system reform. In part 2 of the 2023 session recap, we turn our attention to bills that aimed to tackle healthcare service and pharmaceutical costs, coverage, and price transparency. Healthcare Costs and Coverage Californians can expect to be protected from surprising dental or emergency ground medical transportation bills soon. The legislature approved and …
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Source Team Analyzes Importance of New Merger Guidelines for Health Affairs Forefront
Bruce Allain, Managing Editor December 13, 2023
In a new piece published in Health Affairs Forefront titled “How Will the New Draft Merger Guidelines Impact Health Care Markets?”, The Source’s Amy Gu, Katherine Gudiksen, and Jaime King examine new draft Merger Guidelines released by the Federal Trade Commissions and Department of Justice building on a previous executive order intended to strengthen competition and enhance antitrust enforcement. The authors analyze the new guidelines, as well as the harms caused by health care consolidation. The piece concludes that the draft merger guidelines break new ground by addressing the increasingly …
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FTC and California AG Jointly Challenge John Muir’s Acquisition of San Ramon Regional Medical from Tenet Healthcare
Amy Y. Gu, Managing Editor December 7, 2023
See case page: FTC and California v. John Muir Health and Tenet Healthcare Update: On December 15, 2023, John Muir announced it would terminate its proposed deal to acquire Tenet’s remaining interest in San Ramon Medical Center. On December 18th, the FTC and California moved to dismiss their federal court case and the FTC dismissed its administrative challenge. Federal antitrust enforcement continues to pick up pace even as we near the year end. On November 17, the Federal Trade Commission sued to block John Muir Health’s proposed $142.5 million …
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The Source Roundup: December 2023 Edition
Bruce Allain, Managing Editor December 1, 2023
Healthcare Prices and Cost In An Era Of Premium And Provider Price Increases, State Employee Health Plans Target Key Cost Drivers (Health Affairs Forefront) Sabrina Corlette, Karen Davenport Employer-sponsored health insurance premiums have outpaced inflation and are poised for significant rate hikes this year. State Employee Health Plans have been in a prime position to address health care costs. Administrators of these plans identified reference pricing, tiered network plans, and multi-payer purchasing initiatives as having promising results in addressing cost drivers. The Joint Distribution Of High Out-Of-Pocket Burdens, Medical Debt, …
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Oregon Law to Enhance Oversight of Healthcare Mergers & Acquisitions Faces Legal Challenge
Amy Y. Gu, Managing Editor November 15, 2023
In recent years, increased scrutiny over the impacts of consolidation in the healthcare industry has driven both antitrust enforcers and policymakers at the federal and state levels to enhance their efforts to address and remedy the source of the issue by improving oversight and review of potential anticompetitive healthcare mergers and acquisitions, both before and after the transaction. As the federal agencies review and revise their merger review guidelines and reporting requirements, several states have also introduced legislation to enhance their review and oversight authority of healthcare transactions in their …
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