Healthcare Competition and Consolidation Are “All or Nothing” Contracts by Hospital Systems Anti-Competitive? – Evidence from a Recent Antitrust Lawsuit (Journal of Hospital Management and Health Policy) Glenn Melnick, Katya Fonkych Research has consistently shown that hospital prices are a major driver of increasing healthcare costs in the United States, with the expansion of multi-hospital systems contributing highly to this trend. While contracts between hospitals and health plans have been suspected to contribute to increasing prices, these assertions could not be confirmed until recently since many of these contracts have […]

See case page: Sidibe v. Sutter Health   On August 24, the 9th Circuit Court of Appeals heard oral arguments in the appeal of the federal class action Sidibe v. Sutter Health. A jury verdict in March 2022 in the Northern District Court of California had cleared the hospital giant of anticompetitive allegations that were initially filed over a decade ago. The alleged practices were also at issue in the case filed in state court by a labor union that was later joined by the attorney general, UEBT v. Sutter Health. […]

In the 2023-2024 legislative term, the California legislature has introduced a multitude of legislation targeting consolidation and competition in health care, system reform and price and quality transparency. In a two-part series, we highlight some of the noteworthy legislation proposed this session. Part 1 focuses specifically on the State’s efforts to promote a more competitive healthcare market by targeting restraints of trade and consolidation. In Part 2, the focus will shift to proposed bills targeting system reform, price and quality transparency, and prescription drug prices.   Health Care Consolidation California […]

In a New England Journal of Medicine article and accompanying interview, The Source Founder and Distinguished Fellow Jaime S. King provides an overview of the history of healthcare antitrust law and enforcement and discusses the functions of antitrust law and the effects of health care consolidation on prices, quality of care, and access to care. The perspective piece asserts that combining competitive and regulatory forces may offer the only hope for controlling health care prices, restoring high-quality care, protecting health care workers, and preserving and expanding access to care. Check out […]

See case page: Sidibe v. Sutter Health   After the state action UEBT v. Sutter Health settled prior to trial, the Sidibe class action in federal court continued to shine the spotlight on hospital giant Sutter Health. In March 2022, a jury verdict in the Northern District Court of California cleared Sutter of anticompetitive allegations in this decade-long case. Class plaintiffs swiftly filed an appeal in the Ninth Circuit Court of Appeals to overturn the decision, citing inaccurate jury instructions and exclusion of key evidence that impacted the final outcome of […]

Anticompetitive contracting practices have been under antitrust enforcement scrutiny from both state regulators and private parties in recent years. In California, hospital giant Sutter Health faced several high-profile lawsuits for its alleged anticompetitive contracts. While the state case led by the California attorney general settled earlier this year, the federal class action is on its way to the 9th Circuit appeal. HCA Healthcare, a large health system in North Carolina, appear to be the next health system under litigation fire for similar practices. Three separate actions have been filed by […]

As federal agencies including the FTC and DOJ step up antitrust enforcement efforts in response to Biden’s executive order to revamp competition in the healthcare market, more and more healthcare entities are turning to less traditional consolidation that did not previously trigger antitrust scrutiny, such as “cross-market” mergers, which involve providers that do not directly compete in the same geographic market.[1] This month in Litigation and Enforcement Highlights, we take a look at the latest merger review and conditional approval of a proposed cross-market transaction in California, the third of […]

It’s been a busy month in healthcare antitrust land, both for federal regulators and private plaintiffs, as we saw an explosion of enforcement actions challenging both proposed mergers and anticompetitive conduct that stemmed from previous mergers. From New Jersey to Utah, large health systems such as HCA are being increasingly scrutinized and coming under fire for garnering and using their market power in anticompetitive ways.   Merger Challenges Fresh from its appeals court win in the Hackensack Meridian and Englewood merger challenge, the Federal Trade Commission (FTC) is continuing its […]

See case page: Sidibe v. Sutter Health   The antitrust action against Northern California hospital giant Sutter Health is a saga that continues to give and capture the attention of antitrust regulators and stakeholders around the country. After Sutter’s landmark settlement with the California attorney general in state court in 2019 and a jury verdict in March 2022 clearing Sutter of anticompetitive allegations in a decade-long federal class action, many thought the Sutter chapter had finally closed, albeit somewhat anti-climatically. Not so fast. In late April, plaintiffs in the federal action […]

Consistent research has shown that consolidation in the health industry leads to an increase in healthcare costs without improved quality of care. Though many healthcare mergers have previously gone unchecked, antitrust enforcers are increasingly using their statutory and regulatory authority and the court system to address healthcare consolidation concerns.[1] In California, the attorney general has had the statutory authority to review non-profit hospital mergers for decades but the limited oversight does not extend over all anticompetitive transactions and behavior. This session, the legislature introduced AB 2080 aimed to broaden existing […]