In the 2020 legislative session, California attempted to markedly expand the attorney general’s (AG) powers to intervene in healthcare acquisitions and changes of control. Senate Bill (SB) 977 would have required AG approval before for-profit healthcare entities could consolidate in California. The passage of SB 977 would have been historic and a massive step in antitrust enforcement in the healthcare industry. Unfortunately, SB 977 failed this session without ever being discussed in the Assembly or the Senate. In this post, we review what SB 977 could have done, why it …

As unrelenting consolidation in healthcare provider and insurer markets continues, policymakers need additional options to protect the public from escalating healthcare prices and low-quality care. High healthcare prices result from multiple factors, including third-party payers dampening consumers’ price sensitivity, patients and providers demanding expensive healthcare technologies, and healthcare markets consolidating. While these factors are visible, dominant insurers and healthcare providers can also use terms in their insurer-provider contracts in anticompetitive ways that thwart competition and lead to higher prices or lower quality but remain hidden from public view. With support …

This month in health policy research, surprise billing and changes in market structures fuel concerns about competition and consumer choice.  In addition, some studies on pharmaceutical costs produced hopeful reports.   Healthcare Market Competition and Consolidation Consolidation Trends In a Health Affairs study, Consolidation of Providers into Health Systems Increased Substantially, 2016-18, Michael Furukawa et al. analyzed provider consolidation trends.  The rate of physician affiliation with a health system increased by 11 to 51 percent in 2018.  Based on the 556 health systems the authors identified, the median number of …

See case page: UFCW & Employers Benefit Trust v. Sutter Health After much delay due to the pandemic induced hiatus, the preliminary approval hearing for the proposed settlement agreement in the Sutter Health antitrust case resumed on August 12 at the Superior Court of San Francisco. At the hearing, plaintiff attorneys on behalf of both class members UEBT and the Attorney General addressed in turn questions with respect to specific proposed terms raised in a tentative ruling by Judge Anne-Christine Massullo.[1] One key issue the court rested on was the selection …

Executive Editor Jaime King was quoted in the 7/30/2020 New Times San Luis Obispo article Big health: A look at how the Central Coast’s two hospital systems shape local health care costs: “The data is incredibly clear on this,” said Jaime King, a professor at UC Hastings College of Law who specializes in health care markets and policy. “Hospital mergers result in significant price increases almost immediately. Both entities’ prices go up as a result. Neighboring hospitals’ prices go up, too, as a shadow effect. It’s having an even bigger effect …

The Nevada Patient Protection Commission Presentation on drivers of healthcare costs and efforts to improve transparency in healthcare pricing Presentation: “Addressing High Health Care Prices: Transparency, Enforcement, and Legislation” Meeting Recording Meeting Minutes

See case page: UFCW & Employers Benefit Trust v. Sutter Health At a July 9 hearing at the Superior Court of San Francisco, Judge Anne-Christine Massullo denied Sutter Health’s motion to delay the approval hearing of the preliminary settlement agreement due to the COVID-19 pandemic. This is an encouraging ruling as there was much speculation and concern that Sutter’s request is a thinly veiled attempt to walk back the historic settlement reached last December amidst the chaos of COVID-19. In a California Healthline quote last month, The Source Executive Editor …

After much anticipation and a round of public comments on the draft guidelines released in January, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), officially issued the final Vertical Merger Review Guidelines, replacing the Non-Horizontal Merger Guidelines originally issued in 1984. The updated guidelines govern how federal antitrust agencies evaluate vertical, as well as other non-horizontal mergers. The guidelines outline three main sources of evidence for potential adverse competitive effects from vertical mergers: 1) Foreclosure and Raising Rivals’ Costs, 2) Access to Competitively Sensitive Information, and …

The Source continues to extend wishes of safety and good health to you and your loved ones.  As the pandemic causes the healthcare industry financial tragedy, health law experts share important considerations for policymakers, providers, and payers.  Many authors hope the pandemic will effect much-needed lasting improvements in the efficiency and efficacy of health care in the U.S.   Antitrust Experts Recommend More Rigorous Regulation of Healthcare Consolidation In Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States, published by the Source on Healthcare Price & Competition, authors Jaime King, et …

Case page: UFCW & Employers Benefit Trust v. Sutter Health Executive Editor Jaime King was quoted in the 6/17/2020 California Healthline article Citing COVID, Sutter Pushes To Revisit Landmark Antitrust Settlement: In its filing, Sutter does not specifically object to the $575 million settlement amount. But Jaime King, an associate dean at UC Hastings College of the Law who has followed the case, said the request for a delay could be a tactical strategy to support such a move. “The longer they can delay, the more they can show they have …