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 …

In this month’s Source Roundup, we start out with the latest articles and reports that examine consolidation and lack of competition in the healthcare markets, specifically 1) the impact of certificate of public advantage legislation and 2) the impact of dialysis consolidation on Medicare Advantage beneficiaries. We also highlight a few articles discussing healthcare prices and costs, including 3) the impact of inflation on the healthcare sector, 4) the divergence in cost growth between Medicare and the private insurance sector, and 5) factors that cause health spending to rise in …

Breaking: A class action lawsuit has been filed in North Carolina state court against HCA Healthcare and Mission Health, alleging anticompetitive practices in violation of the North Carolina Constitution and antitrust and consumer protection laws. The lawsuit follows HCA’s 2019 acquisition of Mission Health in North Carolina, which was approved with conditions by the North Carolina AG, although none of which were competitive impact conditions. Plaintiffs, who are North Carolina patients, claim that Tennessee-based HCA used market power garnered from the cross-market merger to demand anticompetitive terms in contracts with …

In the most recent legislative session, Indiana enacted a new certificate of public advantage (COPA) law (SB 416) that allows mergers of certain hospitals to receive immunity from claims of state antitrust laws for the duration of the certificate. Specifically, hospitals eligible for the COPA must be located in a predominately rural county with a specific population cap and has no more than two hospitals in the statewide comprehensive trauma care system. Indiana joins 17 other states with existing COPA laws and 1 states with limited COPA laws, mostly enacted …

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, Senior Health Policy Researchers Robert Murray and Katie Gudiksen, and Source Advisory Board Member Bob Berenson of the Urban Institute created a detailed presentation that first provides an overview of Rhode Island’s provider markets and …

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 …

In this edition of the Source Litigation and Enforcement Highlights, we review 1) an action against Allergan’s anticompetitive practice concerning its dry eye treatment Restasis, 2) the final conclusion to a highly contested West Virginia hospital merger, 3) an antitrust suit between Marion Healthcare and Southern Illinois Healthcare, and 4) another proposed Partners Healthcare merger. Shire Defends Its Antitrust Suit Against Allergan In response to Allergan’s motion to dismiss an antitrust suit filed in New Jersey federal court, Shire filed a brief on January 24, 2018, blasting Allergan’s claim that …

In February, we saw assessments of health policy ideas from the level of national health reform right down to very specific cost saving initiatives. This issue of the Roundup will start with the broad and theoretical and move toward the specific. Big picture health reform In Managed Competition in Health Insurance, Stanford economists Liran Einav and Jonathan Levin examine the potential for regulated markets to outperform single payer public insurance. Specifically, they examined the use of managed competition in Medicare as a means of demonstrating how adverse selection and market …

By: Evan Sznol, Source Fellow The Source would like to highlight a newly published paper by Urban Institute researchers Randall R. Bovbjerg & Source Advisory Board member Robert A. Berenson with a summary of this important work.   In “Certificates of Public Advantage: Can They Address Provider Market Power? (Feb. 2015),” published by the Urban Institute, the authors conducted a case study through interviews with relevant stakeholders to determine the impact of a Certificate of Public Advantage (“COPA”) on healthcare delivery and prices and its utility as a policy tool. …