Competition
Update: Daughters of Charity Gets $250M to Stay Afloat
Anne Marie Helm, Managing Editor July 17, 2015
Update (July 17, 2015): The Daughters of Charity hospitals, which sought purchasers due to financial hardship earlier this year, only to be impeded by the California AG, whose onerous conditions were the death knell to Prime’s proposed acquisition, have secured some help in the form of a $250 million capital injection, according to early reports. Private equity firm BlueMountain Capital Management will provide the investment. See below for our earlier posts on the Daughters situation: Update (March 10, 2015): Today Prime announced that it would not go forward with its proposed …
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CPR & HCI3 Release State Price Transparency Report Card with Appendix by The Source
Anne Marie Helm, Managing Editor July 8, 2015
Catalyst for Payment Reform (CPR) and the Health Care Incentives Improvement Group (HCI3) just released the third edition of the Report Card on State Price Transparency Laws. The report highlights the five states that received non-failing grades, all of which received different grades from 2014: New Hampshire (A), Colorado (B), Maine (B), Vermont (C) and Virginia (C). A key feature of the report is Appendix I: An Analysis of Popular Legal Arguments Against Price Transparency, authored by The Source’s editors, Jaime S. King and Anne Marie Helm. We thank CPR and HCI3 …
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Federal Merger Enforcement Timeline
Anne Marie Helm, Managing Editor July 6, 2015
4-28-17: 2nd Circuit affirms District Court Decision to Block Anthem-Cigna Merger On April 28, 2017, a divided panel of the Second Circuit Court of Appeals affirmed the US District Court’s decision that sided with the Department of Justice (DOJ), which argued that the proposed merger violated Section 7 of the Clayton Antitrust Act. Anthem Inc. announced on May 12, 2017 that it would no longer seek to acquire Cigna Corporation. 2-08-17: District Court Blocks Anthem-Cigna Merger On February 8, 2017, the United States District Court for the District of Columbia blocked the proposed merger between …
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Michigan Hospitals Settle with DOJ/State AG Over Scheme Not to Compete
Anne Marie Helm, Managing Editor July 1, 2015
At the end of last month, the Antitrust Division of the Justice Department and the Michigan Attorney General’s Office filed a civil complaint against four Michigan hospitals, alleging the providers had agreed not to compete with one another in violation of Sherman Act §1 and Michigan state law. DOJ and the Michigan AGO filed a proposed settlement (in the form of a proposed final judgment) simultaneously with that complaint, which means that the parties had reached a settlement before either document was filed. This is common practice for the government …
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Academic Articles & Reports Round Up: June 2015
Jaime S. King, Executive Editor and Anne Marie Helm June 30, 2015
It’s officially summer! Exams are over|Moms, Dads, and Grads have celebrated their big days|and the Supreme Court is issuing opinions! After you have read King v. Burwell, take a look at what June had to offer in the realm of healthcare price and competition. The Variety Issue of Health Affairs is a great place to catch up on your summer reading. For a brief overview of what’s in the issue related to markets and prices, check out Alan Weil’s introduction Markets, Prices and Incentives. Be sure to check out Eric …
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Is M&A for Insurers Bad? Ask the Blue Cross Plaintiffs.
Anne Marie Helm, Managing Editor June 25, 2015
The focus of most antitrust concerns in healthcare over the past few years has been provider consolidation and provider market power. But, lately all eyes appear to be on insurers, who, as The Source tweeted on June 16 and the Wall Street Journal echoed three days later, followed by CNBC yesterday, seem to have caught merger fever (ok, we said “consolidation fever,” and we said that they seemed to have caught it from the providers, whereas they didn’t trace the fever’s origin). As the five largest insurers, United Health, Cigna, …
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Issue Brief: Certificates of Need
Source Fellow June 19, 2015
By: Evan Sznol, Source Fellow Certificate of Need Definition A Certificate of Need (“CON”) regime generally prohibits new or existing healthcare providers and facilities from making large capital expenditures or expanding services and facilities unless a genuine public need exists in the relevant geographic market. Private parties must apply for a certificate of need from the state’s health department before proceeding with a development that meets the statutory trigger, which varies from state to state. CON programs are typically used to restrict the growth of high cost healthcare services, long …
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Issue Brief: Most Favored Nation Clauses
Source Fellow June 19, 2015
*Editor’s Note (September 2020): See updated research paper on anticompetitive contract clauses including most-favored-nations clauses for more detailed analysis: “Preventing Anticompetitive Contracting Practices in Healthcare Markets”. By: Evan Sznol, Source Fellow Introduction: What is a Most Favored Nations Clause? The contract provision known as the most favored nations (“MFN”) clause is a promise obtained by a buyer from a seller that the seller will not give a better price to another buyer. In the healthcare context, an MFN clause typically manifests as a provision within a health network plan contract …
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Update on 9th Circuit Appeal of Antitrust Case Against Sutter
Anne Marie Helm, Managing Editor June 8, 2015
June 2015 Update: Since our last post on this case, Sutter filed its answering brief, and the plaintiffs filed their reply in the Ninth Circuit Court of Appeals. As timing would have it, between the answering brief and the reply, the Ninth Circuit decided the St. Luke’s appeal, another case that focused on geographic market definition in a healthcare market, in February of this year (see our blog post on that case). Accordingly, the Sidibe plaintiffs relied heavily on St. Luke’s in their reply brief to argue for a market definition …
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May Articles & Reports Roundup
Jaime S. King, Executive Editor June 2, 2015
Greetings! For the academics among us, its time to wrap up your end of the year grading and see what you’ve been missing in the literature this month. Two themes came out of the literature in May. First, (no surprise to anyone) the American public continues to be frustrated with the lack of transparency and rationality in healthcare prices, but there are some signs of hope. Second, policymakers and academics have proposed numerous payment reforms, which despite their varying degrees of success, only get at a fraction of the problem. …
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