Healthcare Consolidation
Three Things to Know About the Competitive Health Insurance Reform Act
Anna Zaret, Managing Editor April 5, 2017
On March 22nd, House Resolution 372, known as the Competitive Health Insurance Reform Act, passed in the House by a vote of 416 to 7. The bill repeals antitrust exemptions for health insurers created by the McCarran-Ferguson Act of 1945 (15 U.S.C. §§ 1011-1015) (“McCarran-Ferguson”). Unfortunately, despite bipartisan support for this legislation, it is unlikely to significantly improve competition in health insurance markets. The legislation is unlikely to improve health insurance market concentration, or create a robust market for health insurance sales across state lines, despite GOP hopes. The legislation …
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Academic Articles and Reports Roundup: February 2017
Anna Zaret, Managing Editor March 3, 2017
February brought us a number of interesting articles and reports on healthcare price and competition issues. This month’s Roundup covers publications about 1) projected growth in national healthcare expenditures|2) ACA state marketplace competition|3) the relationship between payment reform and provider consolidation|and 4) the impact of the ACA on individual’s ability to buy insurance. We hope you enjoy! Projected Growth in National Health Expenditures Health Affairs published a report on National Health Expenditure Projections: 2016 – 25 by Sean P. Keehan and colleagues. According to the report, healthcare spending will continue …
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Academic Articles and Reports Roundup: January 2017
Anna Zaret, Managing Editor February 4, 2017
As we moved into the first month of 2017, we continued to see articles addressing concerns about healthcare costs and the role of the market in healthcare. This month’s Roundup covers 1) state oversight of vertical integration in healthcare|2) the influence of provider and insurer market share on price negotiations|3) frameworks for analyzing product-hopping antitrust claims|and 4) former President Obama’s comments on “repeal and delay” of the ACA. Source Executive Editor Jaime S. King and Erin Fuse Brown published The Double-Edged Sword of Health Care Integration: Consolidation and Cost Control (Indiana …
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Case Brief: Highlights from the District Court Decision Blocking the Aetna-Humana Merger
Anna Zaret, Managing Editor January 31, 2017
The United States District Court for the District of Columbia recently issued its decision in the Department of Justice’s challenge to the proposed merger between Aetna and Humana, two of the largest health insurance companies in the nation. The complaint filed in July 2016 alleged that the merger violated Section 7 of the Clayton Act. DOJ argued that the merger would substantially lessen competition in two markets: (1) the Medicare Advantage market in 364 counties, and (2) the ACA Exchange market in 17 counties. The decision, issued on January 23, …
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Academic Articles & Reports Roundup: December 2016
Anna Zaret, Managing Editor January 4, 2017
Happy New Year everyone! As we wrapped up 2016, we saw several fascinating and comprehensive articles published on competition issues in health insurance and provider markets, including articles discussing (1) the relationship between insurer market participation and provider market power|(2) economic models of decreased insurance competition|(3) the Anthem-Cigna antitrust trial|and (4) the role of quality in hospital merger cases. We hope you enjoy! Insurer Market Participation &|Provider Market Power Daria Pelech’s article Dropped Out or Pushed Out? Insurance Market Exit and Provider Market Power in Medicare Advantage (Journal of …
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Source Advisory Board Member Thomas Greaney Discusses the Evidence in Anthem-Cigna Merger Trial
Anna Zaret, Managing Editor December 30, 2016
The first phase of the Anthem-Cigna merger trial ended on December 20, 2016 (see our blog post with updates on the trial here). In the case, DOJ is arguing that the $48 billion merger between Anthem and Cigna, two of the nation’s largest health insurers, violates federal antitrust law. To lay out the issues and offer predictions about how the court may decide the case, Health Affairs Blog published this article on the case by Source Advisory Board Member Thomas Greaney titled The Anthem/Cigna Merger Trial: Sifting Through The Evidence. In the post, Professor …
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Academic Articles & Reports Roundup: November 2016
Anna Zaret, Managing Editor December 1, 2016
Happy December! We hope everyone got some rest and had a delicious feast over the Thanksgiving holiday. Our roundup of November academic articles and reports covers publications on the following issues: (1) the effect of the Supreme Court’s decision in Gobeille on All-Payer Claims Databases (APCDs)|(2) pharmaceutical pricing|(3) price transparency tools’ impact on consumer choice of hospital|and (4) cross-market hospital mergers. APCDs In All-Payer Claims Databases – Uses and Expanded Prospects after Gobeille (New England Journal of Medicine), John D. Freedman, Linda Green, and Bruce E. Landon discuss how the …
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FTC Wins Appeal in Pennsylvania Hospital Merger Case
Anna Zaret, Managing Editor September 28, 2016
On Tuesday, the FTC won its appeal in the Third Circuit, and obtained a preliminary injunction temporarily blocking the merger of the two largest hospital systems in the Harrisburg, Pennsylvania, area. The FTC sued to block the merger of Penn State Hershey Medical Center and Pinnacle Health System in December, but in May a district court judge denied the FTC’s motion for a preliminary injunction. Source Advisory Board member Thomas L. Greaney discussed the case in an earlier blog post, which highlighted the challenges posed by a recent string of …
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Academic Articles & Reports Roundup: July 2016
Anne Marie Helm, Managing Editor August 1, 2016
This month, we saw articles and reports that approached the health care cost conundrum from all angles: price transparency|how the ACA fits in|lowering costs, generally|healthcare markets and market places|and the consumer side of things. Add these to your summer reading list! Price Transparency We at The Source were delighted to have provided research on state legislation for HCI3 and Catalyst for Payment Reform’s Report Card on State Price Transparency Laws — July 2016. This was the fourth edition of the Report Card, first issued in 2013. The Report Card carefully …
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Expert Economists Author Letter Clarifying Relevant Product Market Definition for Aetna/Humana Merger Challenge
Anne Marie Helm, Managing Editor July 25, 2016
Last week’s big news was that the Department of Justice and a number of states have challenged Aetna’s proposed merger with Humana. As in any merger challenge, the way that the relevant product and geographic markets are defined is crucial to the court’s determination of whether the merger should be enjoined. According to the DOJ’s (and other states’) complaint, this merger would combine one of the two largest insurers of Medicare Advantage (Humana) with the fourth largest (Aetna). This, the complaint alleges, would further concentrate 364 county Medicare Advantage markets that are …
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