Antitrust Enforcement
The Source Roundup: February 2025 Edition
Kassie Williams February 1, 2025
Healthcare Pricing Can Public Option Plans Improve Affordability? Insights From Colorado (Health Affairs Forefront) Roslyn Murray, Christopher M. Whaley In the face of individuals and families unable to afford increasing insurance premiums due to lack of healthcare insurance competition, a variety of states are considering offering public option plans, commonly for ACA Exchange plans. These plans seek to provide coverage with low premiums by means of capped prices for those who do not meet Medicare or Medicaid requirements nor receive private coverage through employment. The article describes Colorado’s effective public […]
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Suit Filed Against Epic May Address Crucial Issues Around Healthcare Data
Bruce Allain, Managing Editor October 15, 2024
On September 23, 2024, Particle Health, a startup that aggregates and shares data among healthcare providers and health technology companies, filed suit in the U.S. District Court for the Southern District of New York against Epic Systems, the nation’s largest vendor of electronic health records. The suit alleges that Epic is using its market power to destroy competition and represents a challenge to Epic’s dominance in the patient data marketplace. Parties to the Suit Epic is a software company that provides electronic health record (EHR) resources for hospitals and health […]
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Governor Newsom Vetoes AB-3129 Bill Which Would Have Increased Oversight of Healthcare Transactions Involving Private Equity and Hedge Funds
Dilani Logan, Student Fellow October 7, 2024
On September 28, 2024, Governor Gavin Newsom vetoed Assembly Bill (AB) 3129. The landmark bill would have added restrictions around how private equity groups (PEGs) and hedge funds could participate in the ownership and management of California healthcare facilities. Introduced by Assemblymember Jim Wood and Attorney General (AG) Rob Bonta this past February, supporters of the bill had been optimistic about the bill’s potential impact on healthcare consumers and on the broader healthcare market. In this month’s California Legislative Beat, we examine how this bill could have changed healthcare transactions […]
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The Source Roundup: August 2024 Edition
Bruce Allain, Managing Editor August 1, 2024
Healthcare Competition and Consolidation Medicare Advantage and Consolidation’s New Frontier — The Danger of UnitedHealthcare for All (New England Journal of Medicine) Hayden Rooke-Ley, Soleil Shah, and Erin C. Fuse Brown This article describes the recent ransomware attack on Change Healthcare and the ownership structure of UnitedHealth Group, including how much market power it has with medical claims, data analytics, insurance, physicians, PBMs, pharmacies and a bank. The authors note the risks involved in these types of conglomerations, including market abuses that raise costs, erode quality of care, and harm […]
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Could a District Court ruling against the FTC in a hospital merger challenge revive the failing firm defense?
Bruce Allain, Managing Editor July 15, 2024
In late June Novant announced it would abandon attempts to buy two Community Health Systems (CHS) hospitals in North Carolina. This announcement followed a preliminary ruling in Federal District Court for Novant and a subsequent appellate court ruling for the Federal Trade Commission (FTC). Regardless of the final outcome of the merger, the preliminary Novant win is significant because it represents a successful use of the often cited, rarely successful, “failing firm” defense – which parties can potentially use to push through a merger that would otherwise create an unacceptable […]
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The Source Roundup: July 2024 Edition
Kassie Williams July 1, 2024
Mergers, Acquisitions and Healthcare Competition Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector? (American Economic Association) Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, Lev Klarnet From 2002 to 2020, there were more than 1,100 hospital mergers with a 1% enforcement rate by the FTC resulting in only 13 blocked transactions. The authors of this study speculate low rates of enforcement could be due to factors including budgetary issues and jurisprudence that favors mergers. It is estimated these mergers resulted in a high concentration of hospital markets in “90% […]
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Federal Court Dismisses Case Challenging Oregon’s Merger Review Law
Bruce Allain, Managing Editor June 14, 2024
On May 16, 2024, a Federal District Court Judge dismissed a case filed in 2022 by the Oregon Association of Hospitals and Health Systems (OAHHS, the trade group representing hospitals in Oregon) against the State of Oregon and the Oregon Health Authority (OHA). The suit challenged the law created by Oregon HB 2362, 2021 legislation that required health care entities that meet minimum thresholds to obtain state approval before any mergers or acquisitions. The new law created the Health Care Market Oversight (HCMO) program, housed within the Oregon Health Authority […]
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The Source Roundup: June 2024 Edition
Kassie Williams June 1, 2024
Effects of Market Consolidation Cost, Quality, and Utilization After Hospital-Physician and Hospital-Post Acute Care Vertical Integration: A Systematic Review (Medical Care Research and Review) Alexandra Harris, Sarah Philbin, Brady Post, Neil Jordan, Molly Beestrum, Richard Epstein, Megan McHugh To determine the impact of vertical integration, the authors examine the associations between two types of integration, hospital-physician and hospital-Post Acute Care (PAC), and their effect on cost, quality, and utilization of healthcare services as they relate to affordable care. Assessment of these impacts through the lens of financial benefits the found […]
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The Source Roundup: May 2024 Edition
Dilani Logan, Student Fellow May 1, 2024
Healthcare Cost and Spending Promoting Value-Based Healthcare Decisions: A Case Study of Shared Savings Programs in New Hampshire and Maine (Pepperdine Policy Review) Christopher LaCreta and Lawson Mansell Shared savings programs (SSPs) are an emerging policy solution to combatting the rise of healthcare costs. SSPs enable patients to compare prices and receive incentives for saving money on some elective services. Researchers from Pepperdine University’s School of Public Policy recently published results from their case study on the disparities between SSPs in Maine and New Hampshire. Both states passed legislation to […]
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Recent lawsuits focus on key competition issues
Bruce Allain, Managing Editor April 16, 2024
This spring, court cases are dealing with a variety of issues relevant to healthcare marketplace competition issues. These include a Federal Trade Commission’s (FTC’s) action to block a sale of hospitals in North Carolina, examining the fiduciary duties employer-sponsored health plans have in selecting drug plans, and looking at the acceptability of non-compete clauses in physician contracts. FTC Files suit in North Carolina In February, the FTC authorization of a suit to block Novant Health’s proposed acquisition of two hospitals owned by Community Health Systems (CHS) in North Carolina. On […]
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