We kick off the new year with a handful of new developments in healthcare litigation and enforcement that transpired at the end of 2020. In price transparency, a pair of legal challenges intended to block transparency efforts in drug pricing and hospital pricing, respectively, were denied by the circuit courts. On the antitrust front, the Federal Trade Commission saw both victory and defeat in its challenges of proposed mergers that would lessen competition in the healthcare markets.   Judges Refuses to Block California’s Drug Pricing Transparency Law SB 17 On …

The Source kicked off the New Year with a trio of blog posts in the Health Affairs Blog that highlights the Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ). The SLIHCQ Database was developed in partnership with the Catalyst for Payment Reform (“CPR”) and is an interactive tool that hosts ongoing state legislative efforts to implement healthcare reform. It is intuitively designed to allow policymakers and other stakeholders to customize and filter their searches by key issue and state. In collaboration with CPR, The Source Executive Editor Jaime …

Happy New Year Source readers! In this month’s roundup, we take a look back at the last health policy articles of 2020 and look ahead to what 2021 holds. These pieces examine the continuing rise of national healthcare spending, the impacts of health market consolidation under the guise of healthcare delivery integration, the importance of state-level all-claims payer databases (APCDs), and the potential healthcare system reforms under the Biden administration.   Healthcare Costs Underpinning most topics in this roundup is the issue of healthcare costs, prices, and spending. According to …

As the COVID-19 pandemic continues to ravage the nation, it has put economic stress on smaller healthcare providers, giving larger health systems the opportunity to gain market power through more rampant merger and acquisition activity. In response, the Federal Trade Commission and the Department of Justice also stepped up their antitrust enforcement efforts. In this year-end Litigation and Enforcement Highlights issue, we round up federal enforcement challenges of provider mergers in 2020 and look at the latest status of these actions.   Jefferson Health/Albert Einstein (Pennsylvania) The Federal Trade Commission …

In a new 60 Minutes episode aired on 12/13/20 (S53 E15), CBS interviews California attorney general Xavier Becerra in its investigation of anticompetitive practices by Sutter Health that led to higher health care costs in California. Watch the story here.

In the final monthly roundup of this tumultuous year, we highlight articles and reports that examine 1) rising and varying healthcare costs and their pronounced impact on Americans during the pandemic; 2) antitrust enforcement challenges of private equity partial ownership and joint ventures; 3) continued success of the Affordable Care Act in both marketplace participation and coverage protections for Americans amidst the pandemic; and 4) value-based pricing for COVID-19 treatment and vaccines.   Rising and Varying Healthcare Costs Increase Burden to Americans In the Kaiser Family Foundation report How costly …

Editor’s Note: An abbreviated summary of this case appears in the research report “Preventing Anticompetitive Contracting Practices in Healthcare Markets”, which provides a detailed analysis of anti-tiering/anti-steering clauses, including economic justification and procompetitive use and states that have restricted its use in healthcare contracts.   The antitrust case against Sutter Health in California has drawn the attention of state regulators and policymakers across the country, spawning legislative reform efforts to curb dominant hospitals’ market power. Prior to this, an enforcement action against Atrium Health, a large health system on the …

On November 13, The Source on Healthcare Price & Competition and the UC Berkeley Petris Center jointly hosted a virtual convening of some of the leading experts in law and economics in a workshop to review and evaluate current findings of our collaborative research series “The Role of States in Promoting Competition in Healthcare: A Legal and Economic Analysis.” Our research analyzes how state merger review authority and regulation of contracts between providers and insurers affect the price of healthcare services and insurance premiums. The interactive workshop, supported by Arnold …

This month’s roundup arrives in the wake of the confirmation of a new Supreme Court justice, the final days of the 2020 presidential election, and record-breaking numbers of COVID-19 cases. In light of this historic time, we highlight articles and reports about the implications of the Supreme Court’s new dynamics for healthcare policy, health insurance coverage and affordability as discussed during the 2020 election, and the COVID-19 pandemic’s continuing impact on healthcare costs and coverage. We also look at the continuing effect of increasing consolidation in both the insurer and …

The private antitrust case against Blue Shield/Blue Cross (BCBS) reached a preliminary partial settlement last month after eight years of litigation. A driving force for this settlement may have been the April 2018 district court ruling that was seen as a serious blow to the defendants. In two antitrust suits that have been consolidated in Alabama federal court (put into Multi-District Litigation),[1] healthcare providers and employer subscribers sued BCBS companies across the country, alleging horizontal market allocation in violation of Section 1 of the Sherman Antitrust Act. The plaintiffs claim …