The high-profile antitrust case against Sutter Health settled on the eve of trial in October 2019, when the Northern California hospital giant reached a preliminary settlement agreement with the California Attorney General’s office and class action plaintiffs after five years of litigation. The terms of the settlement were released late December, which include both monetary compensation for the private plaintiffs and injunctions against Sutter’s conduct that will restore competition and promote transparency in the provider market. In this post, we dissect the terms of the proposed settlement agreement and discuss …

On January 10, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), released a new draft guideline for vertical merger review. As opposed to horizontal mergers, vertical mergers generally combine entities that operate at different levels in the same supply chain. As vertical mergers become more commonplace in the healthcare industry, they are increasingly raising antitrust concerns as they often times don’t trigger the same level of scrutiny as do horizontal mergers. The much needed new guidelines specifically targeting vertical mergers serve to withdraw and update the …

On January 10, California Governor Gavin Newsom released his 2020-2021 State Budget proposal. While the state budget process will not begin in earnest until after the Governor’s May Revise, the state budget provides a glimpse of likely California health care reforms. The Governor’s January Budget Proposal proposes the following: Proposal Goals Office of Health Care Affordability Increase price and quality transparency Develop cost targets for health care industry Address hospital cost trends by region, with focus on cost increases driven by delivery system consolidation Establish standards for advance evidence-based and …

Happy New Year! We hope you had an exciting start to the new decade! In this edition of the Source Roundup, we cover articles and reports from December that discuss: (1) increase in US health care spending in 2018, (2) health system affiliation and how it affects patient access, (3) out-of-network provider charges between 2012 and 2017, and (4) how billing in-network could save millions.   U.S. Health Care Spending Increased 4.6 Percent to Reach $3.6 Trillion in 2018 In the Health Affairs article National Health Care Spending in 2018: …

Today, California Attorney General Xavier Becerra announced the settlement terms for the landmark antitrust case, UFCW & Employers Benefit Trust v. Sutter Health. Sutter Health was alleged to engage in anticompetitive behavior by requiring “all or nothing” contracts, preventing insurance companies from providing tiered health plans, setting extremely high out-of-network rates, and restricting price transparency of provider cost information and rates. As Source Executive Editor Jaime King explains in a Tradeoffs episode, The Train Has Left the Station, “[t]his is a huge case. Sutter is a huge entity in Northern …

The Source on Healthcare Price and Competition is excited to announce that, in partnership with UC Berkeley’s Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, we are unveiling a brand new interactive “Market Consolidation” key issue page that presents evidence-based information and analyses on the most effective strategies for states to address rapidly consolidating healthcare markets. Recent evidence demonstrates that provider and insurer markets in the United States have been highly concentrated for years and have led to increased healthcare prices and insurance premiums without a commensurate …

Happy December! The holiday season is upon us and it is time to cozy up with a warm cup of tea to the latest health policy news.  This edition of the Source Roundup looks at articles on 1) healthcare market consolidation and provider network access, 2) increases in insurance premium contributions and deductibles, and 3) lessons from healthcare system reforms abroad.   Healthcare Markets Accountable care organizations (ACOs) have been lauded for providing higher quality medical care at lower costs.  In a recent Health Affairs research article, Changes in Physician Consolidation …

As the healthcare industry grapples with the recent settlement of the antitrust case against Sutter Health, The Source Executive Editor Jaime King discusses the possible motivations and implications of this development in Tradeoffs, a healthcare podcast. In Episode 2 of the podcast, The Train Has Left the Station, Professor King points out that because Sutter is a model for many other health systems around the country, the lawsuit against Sutter’s contracting practices, including all or nothing provisions, had the potential to send shockwaves through the system. The actual implications of …

The historic court case against Sutter Health alleging anticompetitive contract practices took an unexpected turn today when Judge Anne-Christine Massullo of the Superior Court of San Francisco dismissed the jury, announcing that Sutter has reached a preliminary settlement with the California AG and class action plaintiffs. Opening arguments in the case were set for October 21, after it was delayed from October 10 due to an insufficient number of jurors. The trial was estimated to last about 12 weeks and would have put the spotlight on the details of Sutter …

Updated 10/11/19: Start of Trial further delayed to Monday, October 21 per 10/11 hearing regarding jury selection. By: Alex Montague, Graduate Research Fellow Opening arguments for the antitrust case against Sutter Health, set to begin Oct 10 at 10:15am in the Superior Court of San Francisco, were postponed today after the court expressed concern that there was an insufficient number of jurors available to move forward for the trial. Several jurors were absent for today’s trial due to medical conditions and various other reasons, with several more expressing that they …