Healthcare Consolidation
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 […]
Continue Reading Download PDF
Recent Lawsuits Question HRSA Oversight of the 340B Program
Bruce Allain, Managing Editor January 15, 2025
In November of 2024, three lawsuits were filed by pharmaceutical manufacturers against the Department of Health and Human Services (HHS) and the Health Resources and Services Administration (HRSA), challenging how HRSA oversees the Federal 340B Drug Pricing Program. (HRSA is the sub-agency within HHS that administers the 340B Program). The potential impact of the lawsuits on the 340B Program is significant in its own right, but the outcome of the lawsuits could also have an indirect effect on merger and acquisition activity. Research has indicated that the merger and acquisition […]
Continue Reading Download PDF
The Source Roundup: January 2025 Edition
Dilani Logan, Student Fellow January 2, 2025
Price Transparency Hospital Payment Caps Could Save State Employee Health Plans Millions While Keeping Hospital Operating Margins Healthy (Health Affairs) Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan As health insurance premiums continue to rise, state employee health plans are occupying an increasing portion of state budgets. State employers are often the largest purchaser or commercial health insurance in each state, given the volume of employees that they employ. As such, state governments are placed in a unique negotiating position to implement cost containment strategies. […]
Continue Reading Download PDF
The Source Roundup: December 2024 Edition
Dilani Logan, Student Fellow December 2, 2024
Healthcare Competition and Consolidation Chang(ing) Health Care: Bigger May Not Be Better, Just Necessary (Health Affairs Forefront) Atul Grover, Jonathan B. Jaffery As the health care market increasingly trends towards consolidation, many have been left wondering whether the trend towards amalgamated efficiency truly is better. The authors of a new Health Affairs article are arguing that the answer is no. Specifically, they state that the trend towards larger, more consolidated entities is resulting in higher health care costs without marked improvements to quality. As health systems become larger, their power […]
Continue Reading Download PDF
The Source Roundup: November 2024 Edition
Dilani Logan, Student Fellow November 1, 2024
Healthcare Competition and Consolidation Are “All or Nothing” Contracts by Hospital Systems Anti-Competitive? – Evidence from a Recent Antitrust Lawsuit (Journal of Hospital Management and Health Policy) Glenn Melnick, Katya Fonkych Research has consistently shown that hospital prices are a major driver of increasing healthcare costs in the United States, with the expansion of multi-hospital systems contributing highly to this trend. While contracts between hospitals and health plans have been suspected to contribute to increasing prices, these assertions could not be confirmed until recently since many of these contracts have […]
Continue Reading Download PDF
The Source Roundup: October 2024 Edition
Dilani Logan, Student Fellow October 1, 2024
Healthcare Competition and Consolidation The Rise of Health Care Consolidation and What to Do About It (Health Affairs Forefront) Erin C. Fuse Brown, Yashawini Singh, Christopher M. Whaley, Jared Perkins As hospital consolidation continues to meteorically rise, an increasing number of government institutions including the Federal Trade Commission, the Department of Justice, and Congress, have diverted move resources towards understanding and responding to the negative impacts of these trends. The drive towards health care consolidation began in the 1990s and has resulted in a highly concentrated hospital market. Increased consolidation […]
Continue Reading Download PDF
The Source Roundup: September 2024 Edition
Dilani Logan, Student Fellow September 1, 2024
Healthcare Competition and Consolidation Vertical Integration and Market Consolidation in Healthcare: Policy Drivers and Impact on Physicians and Patient Care (Seminars in Colon and Rectal Surgery) Rachel Ekaireb, Anna Yap, and Robert Kucejko Over the past several decades, the healthcare market has become increasingly consolidated. For instance, in the last twelve years alone, the percentage of physicians employed by hospitals or healthcare systems has more than doubled from 26% to 55%. While proponents for vertical integration have touted its potential to improve the efficiency and quality of care delivery, empirical […]
Continue Reading Download PDF
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 […]
Continue Reading Download PDF
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 […]
Continue Reading Download PDF
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% […]
Continue Reading Download PDF