As an extension of the Source’s research and work on provider market consolidation, the Milbank Memorial Fund commissioned the Source team to conduct an in-depth policy analysis of health system consolidation in Rhode Island and provide legal and regulatory options for Rhode Island state officials to address the impacts of consolidation. Executive Director Jaime King and Senior Health Policy Researchers Robert Murray and Katie Gudiksen created a detailed presentation that first provides an overview of Rhode Island’s provider markets and FTC merger review standards. The slide deck then outlines regulatory …

February 19th was the deadline for California legislators to introduce their proposed bills this session.  In a two-part series, we highlight some of the notable healthcare bills on the table in 2021.  In this post, we focus on a few ambitious reform efforts to the healthcare market and delivery system.  Next month, we’ll turn our attention to proposed bills that aim to regulate the prescription drug market and bills that promote price and quality transparency. Healthcare system reform measures are those that change the structure of health care in a …

In this month’s Litigation and Enforcement Highlights, we provide the latest updates on several proposed provider mergers, many of which were fueled by the continued pandemic. With the increased consolidation came increased antitrust scrutiny. So far this year, we’ve seen a mixed bag of wins and losses for federal and state enforcement agencies that seek to block the mergers.   FTC Concedes in Failed Challenge of Jefferson-Albert Einstein Merger In its first major loss in a healthcare merger challenge in recent years, the Federal Trade Commission (FTC) officially dropped its …

The COVID-19 pandemic has brought national attention to the inner workings of the healthcare industry, exposing many of its shortcomings and issues. Many are now taking a renewed look at the U.S. healthcare system as a whole and the underlying problems that arise from the actions of its various players. Early this year, healthcare transactions that have largely escaped federal antitrust review are now being hauled into the spotlight in new attempts to promote greater competition in the healthcare market.   Physician Consolidation Garners Attention as the FTC Seeks to …

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 …

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 …