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California AG Considers Cross-Market Effects in Merger Review and Conditional Approval of USC Health System and Methodist Hospital Affiliation
Amy Y. Gu, Managing Editor July 14, 2022
As federal agencies including the FTC and DOJ step up antitrust enforcement efforts in response to Biden’s executive order to revamp competition in the healthcare market, more and more healthcare entities are turning to less traditional consolidation that did not previously trigger antitrust scrutiny, such as “cross-market” mergers, which involve providers that do not directly compete in the same geographic market.[1] This month in Litigation and Enforcement Highlights, we take a look at the latest merger review and conditional approval of a proposed cross-market transaction in California, the third of …
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Rate Regulation Can Help Redirect Providers to Compete on Non-Price Dimensions of Care
Robert Murray, Senior Health Policy Researcher July 8, 2022
This Blog provides supplementary comments on the recent Health Affairs article entitled “How Price Regulation Is Needed To Advance Market Competition” authored by Robert Berenson and Robert Murray.[1] The idea for the article was stimulated by conversations Bob Berenson and I have had in recent years regarding government administered pricing systems and market competition. Conventional U.S. health policy has asserted that these two approaches represent mutually exclusive strategies to address the issue of high and rapidly rising commercial health care prices. In our Health Affairs article, we attempt to refute …
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The Source Roundup: July 2022 Edition
Enne Mae Guerrero, Graduate Research Fellow July 1, 2022
Happy Summer! We kick off the holiday weekend with the latest research and articles in healthcare price and competition. This month’s Roundup highlights articles and reports that discuss 1) the impact and trends of private equity investment in health care; 2) compliance trends of the federal Hospital Price Transparency Rule; and 3) the role of high prices in excess healthcare spending in the U.S. and possible strategies for cost containment, including methods to limit costs and spending, such as 4) health savings accounts, 5) out-of-pocket spending limit for Medicare, and …
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Q2 2022: Antitrust Enforcement Actions Flourish Against Healthcare Consolidation and Anticompetitive Contracting
Amy Y. Gu, Managing Editor June 14, 2022
It’s been a busy month in healthcare antitrust land, both for federal regulators and private plaintiffs, as we saw an explosion of enforcement actions challenging both proposed mergers and anticompetitive conduct that stemmed from previous mergers. From New Jersey to Utah, large health systems such as HCA are being increasingly scrutinized and coming under fire for garnering and using their market power in anticompetitive ways. Merger Challenges Fresh from its appeals court win in the Hackensack Meridian and Englewood merger challenge, the Federal Trade Commission (FTC) is continuing its …
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The May Revise and Final 2022-2023 State Budget Proposal
Enne Mae Guerrero, Graduate Research Fellow June 13, 2022
Last month, California Governor Gavin Newsom released the May Revise (Revise) of his initial 2022-23 state budget proposal, projecting the largest spending plan of $300.6 billion for the fiscal year.[1] The governor’s initial budget, introduced in January, proposed a $286.4 billion spending plan. The May Revise addresses many of the concerns that have arisen since the release of the initial budget proposal, including the expiration of federal subsidies provided during the COVID-19 pandemic and a broad-based relief package addressing rising inflation concerns. In this post, we provide an overview of …
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The Source Roundup: June 2022 Edition
Enne Mae Guerrero, Graduate Research Fellow June 1, 2022
This month’s Roundup highlights articles and reports discussing the need for improved, adequate monitoring of healthcare consolidation, including 1) vertical integration and joint contracting between physicians and hospital and 2) pharmaceutical mergers. We also examine articles studying healthcare cost affordability, specifically 3) the significant disparities in prices paid to hospitals by private plans and Medicare and 4) California’s improvements in healthcare affordability and access. Finally, we look at some proposed cost containment strategies such as 5) key areas to improve competition to reduce costs and 6) price caps on out-of-network …
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[Sutter Case Watch] Sidibe v. Sutter Health Class Action Headed to Appeal
Amy Y. Gu, Managing Editor May 16, 2022
See case page: Sidibe v. Sutter Health The antitrust action against Northern California hospital giant Sutter Health is a saga that continues to give and capture the attention of antitrust regulators and stakeholders around the country. After Sutter’s landmark settlement with the California attorney general in state court in 2019 and a jury verdict in March 2022 clearing Sutter of anticompetitive allegations in a decade-long federal class action, many thought the Sutter chapter had finally closed, albeit somewhat anti-climatically. Not so fast. In late April, plaintiffs in the federal action …
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AB 2080: A Statutory Solution to Addressing Anticompetitive Transaction & Behavior in the Healthcare Market
Enne Mae Guerrero, Graduate Research Fellow May 16, 2022
Consistent research has shown that consolidation in the health industry leads to an increase in healthcare costs without improved quality of care. Though many healthcare mergers have previously gone unchecked, antitrust enforcers are increasingly using their statutory and regulatory authority and the court system to address healthcare consolidation concerns.[1] In California, the attorney general has had the statutory authority to review non-profit hospital mergers for decades but the limited oversight does not extend over all anticompetitive transactions and behavior. This session, the legislature introduced AB 2080 aimed to broaden existing …
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The Source Roundup: May 2022 Edition
Erin Livinghouse, Student Fellow and Amy Y. Gu, Managing Editor May 2, 2022
This month in The Source Roundup, we cover articles and reports that examine: 1) the effect of private equity acquisition of hospitals; 2) the latest trends on hospital prices; and 3) ACA marketplace premiums at the state level in the last 3 years. Additionally, we highlight several cost containment strategies studied in recent reports, including 4) a progressive taxing proposal co-authored by The Source team, 5) establishing a state cost commission in California with lessons from other states, and 6) purchaser-led efforts to reduce healthcare costs. Consolidation and Competition …
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FTC Successfully Blocks Hackensack Meridian Merger with Big Win in 3rd Circuit Appeal
Amy Y. Gu, Managing Editor April 15, 2022
In the latest healthcare antitrust action, Hackensack Meridian and Englewood Healthcare officially terminated their merger plans after the Third Circuit Court of Appeals handed down a big win for federal regulators in the merger challenge. Last month, after multiple amicus briefs filed by various stakeholders in the appeals court, a three-judge panel affirmed the lower court’s preliminary injunction to block the merger, holding that the Federal Trade Commission (FTC) established a prima facie case showing that the proposed merger is likely to substantially lessen competition and that the hospitals’ procompetitive …
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