Healthcare Markets and Acquisitions Health Insurance After Corporatization —What Next? New England Journal of Medicine Perspective Leemore Dafny, Ph.D. The author explores whether the corporatization of the U.S. health insurance industry (i.e., the consolidation of insurers within and across markets) contributes to the industry’s poor performance among the commercially insured population. The answer is maybe. One key driver of such consolidation is the “technology of insurance.” Economies of scale drive insurance consolidation by lowering costs and stabilizing risk for larger insurers, but beyond a certain size, these advantages fade, and […]

Healthcare Costs Growth In National Health Expenditures: It’s Not The Prices, Stupid Health Affairs Michael Chernew The article seeks to identify the causes of rising healthcare costs by assessing trends across sectors, including coding intensity, AI medical services, product costs, and healthcare consolidation and administrative shifts. Chernew reports that coding intensity has increased and explores the possible relationship to AI medical services, though notes it may be too early to identify any trends. Broad healthcare infrastructure changes show conflicting trends in prices, and the author advocates for more focus on […]

Antitrust Enforcement Fixing a Broken System: Policy Responses to Hospital Acquisitions of Physician Practices That Limit Health Care Access for U.S. Consumers Progressive Policy Institute Diana Moss, Alix Ware, Lief Lin By 2023, more than half of all independent physician practices (IPPs) were no longer independent, but owned by hospitals, health systems, or corporate entities, meaning 78% of all U.S. physicians were employed by large provider organizations. Loss of IPPs through vertical consolidation leads to higher prices, reduced access, loss of physician autonomy, and reduced patient choice. This study highlights […]

This post is part of our ongoing coverage of the CHA v. OHCA lawsuit. See case page here. In this post, we examine the claims made by the California Hospital Association (CHA) in its recent lawsuit filed against the California Office of Health Care Affordability (OHCA) regarding OHCA’s plan to implement spending targets for hospitals (Case #  CPF25519370).  While many stakeholders, including CHA, the California Medical Association (CMA), and others, have expressed concerns about the spending targets announced by OHCA and the methodology used to establish them, dissatisfaction with an administrative […]

October 12 marked the deadline for the California Governor to sign or veto legislation passed during the 2025 California legislative session, so we now know the fate of this year’s healthcare legislation.  Much of the session’s efforts were focused on ensuring support of Californians in the face of massive federal cuts to social programs, Los Angeles wildfires, a potential budget deficit of over $12 billion, and the state’s highly publicized push to get Proposition 50 passed, which will redraw Congressional district maps.  Lawmakers introduced an ambitious slate of bills aimed […]

On October 15, 2025, the California Hospital Association (CHA) filed suit against the California Office of Health Care Affordability (OHCA) (and affiliated defendants) over claims that OHCA’s spending targets are arbitrary, irresponsible and single out hospitals, and will severely disrupt hospital services, starving hospitals of needed resources. The California Legislature created OHCA in 2022 and authorized it: to analyze healthcare markets for cost trends and drivers of spending, to set and enforce cost-growth benchmarks for the state, and to review and assess the impact of mergers, acquisitions, affiliations, and other […]

On June 12th, 2025, Vermont Governor Phil Scott signed S0126 into law, in which the state aims to improve quality of care and healthcare access by stabilizing healthcare costs through Medicare-based price regulation, creating global hospital budgets, and establishing a more stable and high-quality state healthcare network.  The new law intends to do so through controlling costs for commercial insurance, managing hospital costs by using price caps, and overseeing and assessing administrative processes.  The law tasks the Green Mountain Care Board (GMCB) with accomplishing these objectives. Vermont’s current system for […]

Healthcare Consolidation Defining Health Care “Corporatization” (The New England Journal of Medicine) Erin C. Fuse Brown In this brief article, Fuse Brown draws on the prescient work of Paul Starr who, in his 1982 book the Social Transformation of American Medicine, foretold the coming of large healthcare conglomerates. Through consolidation, concentration, and increased focus on profits over patients, the author asserts that we have reached the “Gilded Age” of medicine, replete with dissatisfaction for all – producers, providers, and consumers. While Starr’s 40-year-old prediction has proven to be largely accurate, Fuse […]

Healthcare Cost Control State Health Care Cost Commissions: Their Priorities and How States’ Political Leanings, Commercial Hospital Prices, and Medicaid Spending Predict Their Establishment (The Milbank Quarterly) Brent D. Fulton, Daniel R. Arnold, Jordan M. Wolf, Richard M. Scheffler As healthcare costs continue to rise, states play an increasingly important role in addressing affordability and cost containment. In this Milbank Quarterly article, researchers examine the political and economic measures in the 17 states that have created Health Care Cost Commissions (HCCCs).  HCCCs are independent administrative bodies usually housed in the […]

Market Consolidation and Merger Review The Forgotten Anti-Monopoly Law: The Second Half of Clayton Act Section 7 (Texas Law Review) Robert H Lande, John M Newman, Rebecca Kelly Slaughter The authors of this article analyze the second prong of Section 7 of the Clayton Act, which prohibits mergers that “tend to create a monopoly.” In comparison to the well-known first prong that seeks to “substantially lessen competition,” the second prong is posited to wield more statutory power as it does not contain a requirement for a certain degree of harm […]