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% …

Effects of Market Consolidation Cost, Quality, and Utilization After Hospital-Physician and Hospital-Post Acute Care Vertical Integration: A Systematic Review (Medical Care Research and Review) Alexandra Harris, Sarah Philbin, Brady Post, Neil Jordan, Molly Beestrum, Richard Epstein, Megan McHugh To determine the impact of vertical integration, the authors examine the associations between two types of integration, hospital-physician and hospital-Post Acute Care (PAC), and their effect on cost, quality, and utilization of healthcare services as they relate to affordable care. Assessment of these impacts through the lens of financial benefits the found …

Healthcare Cost and Spending Promoting Value-Based Healthcare Decisions: A Case Study of Shared Savings Programs in New Hampshire and Maine (Pepperdine Policy Review) Christopher LaCreta and Lawson Mansell Shared savings programs (SSPs) are an emerging policy solution to combatting the rise of healthcare costs. SSPs enable patients to compare prices and receive incentives for saving money on some elective services. Researchers from Pepperdine University’s School of Public Policy recently published results from their case study on the disparities between SSPs in Maine and New Hampshire. Both states passed legislation to …

Healthcare System Mergers and Investments Private Equity-Acquired Physician Practices and Market Penetration Increased Substantially, 2012-21 (Health Affairs) Ola Abdelhadi, Brent D. Fulton, Laura Alexander, and Richard M. Scheffler The awareness for private equity’s influence on the healthcare sector continues to grow and be quantified. Generally, there has been concern among parties in the health care system regarding the rate at which private equity firms have been acquiring physician practices, creating antitrust, quality, and pricing concerns within the broader health system. A new Health Affairs study estimated the local market share …

Health Policy Trends The 2024 CHCF California Health Policy Survey (California Health Care Foundation) Jen Joynt, Rebecca Catterson, Emily Alverez, Larry Bye, Vicki Pineau, and Lin Liu The California Health Care Foundation released results from its fifth annual California Health Policy survey. Researchers from the California Health Care Foundation and NORC at the University of Chicago surveyed a representative sample to assess Californian’s views and experiences on a myriad of health care topics. This year’s survey yielded a number of key findings. Among them, researchers found that there is a …

Healthcare System Mergers and Investment Models for Enhanced Health Care Market Oversight – State Attorneys General, Health Departments, and Independent Oversight Entities (Milbank Memorial Fund) Erin C. Fuse Brown, Katherine L. Gudiksen The Source’s own Katherine L. Gudiksen co-authored this report for the Milbank Memorial Fund with Eric C. Fuse Brown, which assesses the tools state policy makers are using to address harmful health care market consolidation. Specifically, the report focuses on how states have broadened review authority by expanding the existing authority of the Attorney General (or other state …

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 …

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, …

Healthcare Costs and Spending A Study of the Cost of Care Provided in Physician Owned Hospitals Compared to Traditional Hospitals (Physician’s Advocacy Institute and the Physicians Foundation) Robert H. Aseltine and Gregory J. Matthews The Physician’s Advocacy Institution and the Physicians Foundation released a new technical report summarizing their findings from an investigation comparing the cost of care patients across Medicare’s 20 most expensive conditions in 2019 in physician owned hospitals (POHs) and traditional hospitals. The authors assessed the statistical similarities in cost, patient demographics, and comorbidity levels between hospitals in …

Consolidation and Competition A Doctrine in Name Only — Strengthening Prohibitions against the Corporate Practice of Medicine (NEJM) Jane M. Zhu, Hayden Rooke-Ley, and Erin Fuse Brown The NEJM perspective examines state corporate practice of medicine laws that prevent ownership or control of physician practices by corporate entities. In an accompanying audio interview, Erin Fuse Brown discusses the role of these laws, including the usefulness and how they could be strengthened. Competition in Commercial PBM Markets and Vertical Integration of Health Insurers with PBMs: 2023 Update (American Medical Association) José R. …