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 […]

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 […]

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 […]

In a new research paper published in Frontiers in Public Health Volume 11, The Source’s Alex Montague, Robin Davison, Katie Gudiksen, and Jaime King examine the use of conditional approvals by state officials on hospital and health system mergers, acquisitions, and other consolidating transactions. While federal antitrust enforcers play an important role in overseeing large mergers, acquisitions, and other consolidating transactions of major healthcare providers, state oversight over healthcare markets is essential to slow consolidation more broadly and address market failures across the country. One method states have used to address […]

On July 19, the Federal Trade Commission (FTC) and Department of Justice (DOJ) jointly released updated draft guidelines for their antitrust review of mergers and acquisitions. The new proposed guidelines were established following public comments solicited from the past 18 months and aim to better evaluate business and competition in the modern economy and current market realities. The draft guidelines provide 13 principles the agencies will use in determining whether a transaction is anticompetitive and take into consideration increasing concern over new forms of consolidation including vertical mergers, cross-market mergers, […]

In a new paper published in the Harvard Journal on Legislation Volume 59, Issue 1, The Source’s Jaime King and Katie Gudiksen, together with Erin Fuse Brown, discuss state public option proposals from 2010–2021, including from states like Nevada, Colorado, and Washington. In examining the three main models—(1) Medicaid Buy-In Public Options; (2) Marketplace-Based Public Options; and (3) Comprehensive Public Options—the paper considers potential challenges to these state public option plans and whether they are legally viable and “worth it” for states to pursue, given the goal of improving healthcare […]

After months of speculation and opposition from industry groups, the Department of Justice (DOJ), along with attorneys general of New York and Minnesota, filed a lawsuit in federal court in the District of Columbia to block the merger of UnitedHealth and Change Healthcare, just days ahead of the February 27 deadline set for the deal to close. According to the DOJ announcement released on February 24, the lawsuit alleges the proposed $13 billion deal would not only harm competition in commercial health insurance markets, but also the market for technology […]

Updated February 23, 2022: The entities withdrew their application and abandoned the proposed merger in the face of federal and state antitrust challenge. A temporary restraining order was granted on February 18 halting merger proceedings pending court ruling on the request for preliminary injunction. Rhode Island’s two largest nonprofit hospital systems, Lifespan and Care New England, will face a challenging road ahead to their proposed merger. On February 17, the Federal Trade Commission (FTC) voted to file a lawsuit to block the proposed merger in court. Separately, Rhode Island Attorney […]

Health care consolidation has been on the rise for decades, leading to higher health care prices, not higher quality. Today, two-thirds of hospitals in the U.S. are part of a larger health system; almost 1 in 3 physicians now works in a hospital-owned practice. Many regions are dominated by a single system, leaving patients and families without access to affordable, high-quality care.   Arnold Ventures recently released the second video in a series about high health care prices and the impact they have on health care costs and affordability for […]

As states like Nevada, Colorado, and Washington push forward with their state public option efforts, a new article in New England Journal of Medicine, co-authored by Erin Fuse Brown and The Source’s Katie Gudiksen and Jaime King, takes a closer look at the key provisions of each of the plans. The article discusses potential challenges to these state public option plans and most importantly, whether they can effectively improve healthcare coverage and affordability. Listen to Erin Fuse Brown discuss lessons from these states in a podcast for NEJM.