About Bruce Allain, Managing Editor
Bruce Allain, J.D. is the Managing Editor for The Source on Healthcare Price & Competition. Bruce brings two decades of experience in healthcare policy to The Source, having spent years working in government relations and public policy roles for the American Academy of Orthopaedic Surgeons, the American Association of Nurse Anesthesiologists, and AmeriHealth Caritas.The Source Roundup: July 2024 Edition
Bruce Allain, Managing Editor July 1, 2024
Mergers, Acquisitions and Healthcare Competition Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector? (American Economic Association) Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, Lev Klarnet From 2002 to 2020, there were more than 1,100 hospital mergers with a 1% enforcement rate by the FTC resulting in only 13 blocked transactions. The authors of this study speculate low rates of enforcement could be due to factors including budgetary issues and jurisprudence that favors mergers. It is estimated these mergers resulted in a high concentration of hospital markets in “90% …
Continue Reading Download PDF
U.S. Supreme Court Overturns the Chevron Deference: What it Could Mean for Federal Healthcare Agencies
Bruce Allain, Managing Editor June 28, 2024
On a 6-3 decision following party lines, the conservative majority of the U.S. Supreme Court overturned a long-standing legal precedent that required courts to generally defer to regulations issued by Federal agencies that interpret and enact Congressional statutes, commonly referred to as Chevron deference. Chevron deference required courts to defer to an agency’s “reasonable interpretations” of ambiguous statutes passed by Congress. The end of the precedent opens the doors to legal challenges of existing Federal administrative law, and will likely weaken the ability of Federal agencies to issue administrative regulations …
Continue Reading Download PDF
Federal Court Dismisses Case Challenging Oregon’s Merger Review Law
Bruce Allain, Managing Editor June 14, 2024
On May 16, 2024, a Federal District Court Judge dismissed a case filed in 2022 by the Oregon Association of Hospitals and Health Systems (OAHHS, the trade group representing hospitals in Oregon) against the State of Oregon and the Oregon Health Authority (OHA). The suit challenged the law created by Oregon HB 2362, 2021 legislation that required health care entities that meet minimum thresholds to obtain state approval before any mergers or acquisitions. The new law created the Health Care Market Oversight (HCMO) program, housed within the Oregon Health Authority …
Continue Reading Download PDF
Verdict in Sidibe v. Sutter Health Overturned by 9th Circuit Court of Appeals
Bruce Allain, Managing Editor June 5, 2024
On Tuesday, June 4, 2024, the 9th U.S. Circuit Court of Appeals overturned Sutter Health’s win in a $411 million antitrust suit, saying that the jury that found in favor of Sutter in 2022 was given improper jury instructions, and that the plaintiffs were improperly prevented from presenting relevant evidence. In September 2012, a class of individuals and employers who purchased fully insured plans from the five largest commercial health insurance companies in California filed this lawsuit alleging that Sutter Health restricted competition in the healthcare market using anticompetitive tactics. A similar lawsuit, …
Continue Reading Download PDF
FTC’s Non-Compete Ban Hit with Multiple Legal Challenges
Bruce Allain, Managing Editor May 15, 2024
On April 23, 2024, the Federal Trade Commission (FTC) issued a final rule banning many noncompete clauses in employee contracts and several parties quickly filed lawsuits challenging those rules. Only one day after the FTC issued the rule, on April 24, 2024, the Chamber of Commerce of the United States of America, the Business Roundtable, the Texas Association of Business, and the Longview Chamber of Commerce filed suit against the FTC in the United States District Court for the Eastern District of Texas. On April 23, Ryan, a tax services …
Continue Reading Download PDF
California Legislature Considering Bills to Ease CHFFA Hospital Loan Repayment
Bruce Allain, Managing Editor April 30, 2024
Introduction In February 2024, lawmakers in California introduced Assembly Bill 2098 and Assembly Bill 2637. Both bills would make changes to loans offered by the California Health Facilities Financing Authority (CHFFA), an important entity that helps struggling California hospitals. These loans are often essential to communities because they help the local hospitals get back onto sound financial footing. Background The California Legislature created CHFFA in 1979 to provide financial help to hospitals and other healthcare providers via loans that are funded through the issuance of tax-exempt bonds. The financing can be …
Continue Reading Download PDF
The Source Team Co-Authors Research Article Examining Impacts of Cross-Market Hospital Mergers
Bruce Allain, Managing Editor April 23, 2024
A new research article examining the impact of “cross-market” hospital mergers on prices and quality published in Health Services Research has been co-authored by The Source’s own Jaime King, Katherine Gudiksen, Alexandra Montague, and Thomas Greaney, along with our long-time collaborators, Daniel Arnold, Brent Fulton, and Richard Scheffler, from The Petris Center at UC Berkeley. The study is the first to measure the impact of cross-market hospital acquisitions on quality and the first to identify price effects from multiple cross-market acquisitions (i.e. serial acquisitions). The study used commercial claims data …
Continue Reading Download PDF
Recent lawsuits focus on key competition issues
Bruce Allain, Managing Editor April 16, 2024
This spring, court cases are dealing with a variety of issues relevant to healthcare marketplace competition issues. These include a Federal Trade Commission’s (FTC’s) action to block a sale of hospitals in North Carolina, examining the fiduciary duties employer-sponsored health plans have in selecting drug plans, and looking at the acceptability of non-compete clauses in physician contracts. FTC Files suit in North Carolina In February, the FTC authorization of a suit to block Novant Health’s proposed acquisition of two hospitals owned by Community Health Systems (CHS) in North Carolina. On …
Continue Reading Download PDF
Patients File Class Action Suit Claiming Healthcare Merger Resulted in Unfair High Prices
Bruce Allain, Managing Editor March 15, 2024
The preponderance of research evidence demonstrates that a lack of meaningful healthcare market competition is bad for consumers – resulting in higher prices, and insurance premiums, without a commensurate increase in quality of care. New merger guidelines issued in 2023 by the Federal Trade Commission and Department of Justice are just one indication that the Federal government is more closely examining proposed health system mergers. Increased regulatory scrutiny, among other factors, appears to be causing a slow-down in healthcare merger activity. In addition to merger challenges by state and federal …
Continue Reading Download PDF
The Source Team Examines Changes to the Final 2023 Merger Guidelines
Bruce Allain, Managing Editor February 26, 2024
For Health Affairs Forefront, the Source’s Katherine Gudiksen and Jaime King have analyzed changes from the draft version to the final 2023 Merger Guidelines released by the Federal Trade Commission (FTC) and Department of Justice (DOJ). In a previous Health Affairs Forefront piece, Source staff examined the draft guidelines. This new post examines key elements of the new guidelines, concluding that while the final version better aligns the Guidelines with the underlying antitrust laws and caselaw, the Guidelines create more grey area for companies to demonstrate that mergers do not …
Continue Reading Download PDF