Antitrust Enforcement
[Sutter Case Watch] 60 Minutes Episode: “The High Cost of Healing” Highlights Sutter Health Antitrust Case
Amy Y. Gu, Managing Editor December 14, 2020
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.
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The Source Roundup: December 2020 Edition
Amy Y. Gu, Managing Editor December 1, 2020
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 …
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[Case Brief] Atrium Health Settlement Encourages Enforcement of Anti-tiering/Anti-steering Clauses in Healthcare Contracts
Amy Y. Gu, Managing Editor November 16, 2020
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 …
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The Source Convenes Interdisciplinary Panel of Experts and Stakeholders to Inform Policies to Promote Competition in Health Care
Amy Y. Gu, Managing Editor November 16, 2020
On November 13, The Source on Healthcare Price & Competition and the UC Berkeley Petris Center jointly hosted a virtual convening of some of the leading experts in law and economics in a workshop to review and evaluate current findings of our collaborative research series “The Role of States in Promoting Competition in Healthcare: A Legal and Economic Analysis.” Our research analyzes how state merger review authority and regulation of contracts between providers and insurers affect the price of healthcare services and insurance premiums. The interactive workshop, supported by Arnold …
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Blue Cross/Blue Shield Reaches Settlement Agreement with Class Plaintiffs in Private Antitrust Suit
Amy Y. Gu, Managing Editor October 15, 2020
The private antitrust case against Blue Shield/Blue Cross (BCBS) reached a preliminary partial settlement last month after eight years of litigation. A driving force for this settlement may have been the April 2018 district court ruling that was seen as a serious blow to the defendants. In two antitrust suits that have been consolidated in Alabama federal court (put into Multi-District Litigation),[1] healthcare providers and employer subscribers sued BCBS companies across the country, alleging horizontal market allocation in violation of Section 1 of the Sherman Antitrust Act. The plaintiffs claim …
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[Sutter Case Watch] Court Officially Rejects Sutter’s Proposed Settlement Due to Inadequate Compliance Monitor Selection
Amy Y. Gu, Managing Editor October 6, 2020
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 …
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The Source Roundup: October 2020 Edition
Alex Montague, Health Policy Researcher October 1, 2020
With the passing of Justice Ruth Bader Ginsburg and nomination of Amy Coney Barret to the Supreme Court just weeks before the presidential election, many are turning their attention to health care and the fate of the Affordable Care Act (ACA). With this backdrop, this month’s Source Roundup looks at 1) what is at stake as the ACA faces the Supreme Court again in California v. Texas, 2) new information about rising healthcare prices, 3) anticompetitive contract practices between providers and insurers, and 4) the potential of a public option …
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The Source Cited in Report on What States Can Learn About Provider Consolidation from the Sutter Health Settlement
Amy Y. Gu, Managing Editor September 23, 2020
Two papers published by The Source were cited in the latest Milbank Memorial Fund report “California’s Sutter Health Settlement: What States Can Learn About Protecting Residents from the Effects of Health Care Provider Consolidation”. The first, “Addressing Health Care Market Consolidation and High Prices”, is co-authored by The Source’s Jaime S. King and Katherine L. Gudiksen, with Robert A. Berenson et al. for the Urban Institute. The second paper is “Preventing Anticompetitive Healthcare Consolidation: Lessons From Five States”, written by Jaime S. King, Samuel M. Chang, et al. and jointly published …
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Post-Mortem Reflection on SB 977: The Significance of What Could’ve and Should’ve Been
Mallory Warner, Health Policy Research Fellow September 16, 2020
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 …
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Just Published: Research Report on Preventing Anticompetitive Contracting Practices in Healthcare Markets
Amy Y. Gu, Managing Editor September 8, 2020
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 …
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