See case page: Sidibe v. Sutter Health   As all eyes were fixated on UFCW & Employers Benefit Trust v. Sutter Health (UEBT), the landmark state antitrust lawsuit that the California attorney general brought against Sutter Health, another long-standing litigation against Sutter in federal court for similar claims has largely gone under the radar. With the final judgment in the state action set to be approved in state court this July, we turn our attention to Sidibe v. Sutter Health, the other case to watch in the ongoing antitrust challenge against …

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 …

See case page: UFCW & Employers Benefit Trust v. Sutter Health In August, The Source reported on the preliminary approval hearing for the proposed settlement of California’s high-profile antitrust suit against Sutter Health. Among other issues, Judge Anne-Christine Massullo of the Superior Court of San Francisco was particularly troubled by the selection process of the independent compliance monitor and required supplemental filings from the parties regarding the selection and outreach process employed in the selection of Jesse Caplan of Affiliated Monitors, whom the parties jointly requested to appoint (see The Source …

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 …

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 …

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 …

See case page: UFCW & Employers Benefit Trust v. Sutter Health When Sutter Health reached a preliminary settlement agreement with California Attorney General Xavier Becerra restricting its anticompetitive practices, antitrust experts breathed a collective sigh of relief on clinching a favorable outcome. Then came COVID-19. As with all other aspects of business and life, the pandemic has turned existing order upside down. Will it throw a wrench in the all but finalized case that would’ve served as strong guidance to other health systems in the country? The terms of the …

We did it again! The Source on Healthcare Price & Competition is proud to announce that, in partnership with UC Berkeley’s Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, we have launched another brand new interactive key issue page, “Provider Contracts”, which looks at the most effective strategies for states to understand and address the ability of providers with dominant market power to utilize contracting strategies to negotiate high rates. With support from Arnold Ventures, this new installment is part of a collaborative research series that leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider …

See UFCW & Employers Benefit Trust v. Sutter Health case page.   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 …

See UFCW & Employers Benefit Trust v. Sutter Health case page.   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, …