Competition
Healthcare Costs & Competition in the 2016 Election
Anna Zaret, Managing Editor October 14, 2016
In the second presidential debate, an undecided voter asked Hillary Clinton and Donald Trump how they would each address high healthcare costs and improve insurance coverage. It was an opportunity for the campaigns to highlight their visions on health policy, which has been outside the spotlight for most of the campaign. Clinton’s answer focused on fixing the rising costs of ACA exchange plans, while Trump argued that the ACA should be repealed, and replaced with rules that allow insurance to be purchased across state lines. There’s a lot to discuss …
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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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Update: Carolinas Healthcare Argues DOJ Fails to Allege Actual Competitive Harm in Anti-Steering Suit
Anna Zaret, Managing Editor September 24, 2016
September 2016 Update: We previously blogged about the suit filed in June by the Department of Justice and the North Carolina Attorney General against Carolinas Healthcare System (“CHS”). The case involves a Sherman Act Section 1 challenge to anti-steering provisions in CHS’ contracts with insurers. In August, CHS moved for judgment on the pleadings. CHS filed its reply brief in support of the motion on Wednesday. In its brief, CHS argues that the DOJ complaint is insufficient as a matter of law because it fails to show that the anti-steering …
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Academic Articles & Reports: August 2016
Anne Marie Helm, Managing Editor September 1, 2016
This last round up of the summer features articles on a range of topics including (1) competition in healthcare markets|(2) strategies for reducing healthcare costs|(3) pharmaceutical pricing|(4) ACOs|(5) other ACA aspects and effects|(6) post-Gobeille strategies|and (7) antitrust enforcement. We hope everyone is settling into school and work after some time off. Happy (almost) fall! Competition in health care markets: In Choice and Competition in Public Service Provision, by Timothy J. Besley and James M. Malcomson, published by the Center for Economic Policy Research, looks broadly at markets involving services like …
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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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Update: Appeals Court Reinstates Florida Plaintiffs’ Class Claims in Challenge to Unreasonable Hospital Rates
Anne Marie Helm, Managing Editor July 20, 2016
July 2016 Update: In April, the U.S. Court of Appeals for the 11th Circuit overturned the district court’s February 2015 decision dismissing the class-wide allegations in this case. The case charges certain Florida medical centers and Nashville, Tenn.-based HCA with billing exorbitant and unreasonable fees for emergency radiological services covered in part by Florida Personal Injury Protection (“PIP”) insurance. Under Florida’s No Fault Car Insurance Law, drivers are required to have $10,000 in PIP insurance, and the complaint alleges that patients covered by PIP who received radiological services at emergency rooms following …
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Sutter Plaintiffs Win 9th Circuit Appeal of 2014 Case Dismissal
Anne Marie Helm, Managing Editor July 18, 2016
At long last, a three-judge panel has ruled in favor of the plaintiffs/appellants in their Ninth Circuit appeal of the dismissal of the putative class action Sidibe v. Sutter Health, filed in federal district court in San Francisco in September 2012 and dismissed in June 2014. The Ninth Circuit heard arguments on July 8, and issued this unpublished opinion a week later. The district court dismissed the third amended complaint on the grounds that the plaintiffs’ geographic market definition, one of the bases for claims brought under the Sherman Antitrust …
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The FTC’s Hospital Merger Program: Coming A Cropper?
Guest Author July 12, 2016
By Guest Blogger: Professor Thomas L. Greaney Federal antitrust oversight of hospital consolidation has come upon hard times. Over the last two months the Federal Trade Commission suffered three notable setbacks in challenges to hospital mergers. Federal district courts in Pennsylvania and Illinois have refused to issue preliminary injunctions in cases in which the agency claimed the combined market shares of the merging parties were in excess of 64 and 50 percent respectively. Both cases turned largely on disputes over defining the always-elusive “relevant geographic market” in which merging hospitals compete. …
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California Dept. of Insurance Asks DOJ to Block Anthem-Cigna Deal
Anne Marie Helm, Managing Editor June 16, 2016
Update: On June 16, 2016, 10 weeks after holding hearings on the proposed Anthem-Cigna merger, Insurance Commissioner Jones reported his department’s determination that the merger would be anti-competitive and that access, quality, and affordability would suffer as a result of the transaction. The text of the press release is as follows: SACRAMENTO, Calif. – California Insurance Commissioner Dave Jones today urged the U.S. Department of Justice to block the merger deal between Anthem, Inc., and Cigna Corporation. After an extensive review of the Anthem and Cigna merger, Commissioner Jones issued detailed findings that …
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