Competition
April Articles & Reports Roundup
Jaime S. King, Executive Editor May 1, 2015
While April brought us little in the way of showers, it did offer a nice range of articles and reports that focus on competition in health care markets and payment reform initiatives, including accountable care organizations (ACOs). This issue of the Roundup will tackle payment reform initiatives first, then move on to competition, and wrap up with a handful of articles examining state initiatives and opportunities. Payment Reform Initiatives The April academic literature examined the ability of payment reform initiatives, including payment for performance, reference pricing, and provider risk sharing …
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How to fix our hospital pricing problem (and how not to)
Guest Author April 15, 2015
By Guest Blogger: Erin C. Fuse Brown, JD, MPH We are pleased to publish another excellent post by Professor Fuse Brown, originally published here by the Center for Law, Health & Society! The post: Last month, Slate columnist Reihan Salam wrote a provocative article about outrageous hospital prices that are driven, according to Salam, by greed, avarice, and market power. Salam gets a few things dead right, namely his diagnosis that we have a massive hospital pricing problem that is bleeding us dry and that the problem is largely caused by growing hospital market power. However, he misses the …
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St. Luke’s Request for Rehearing Denied
Anne Marie Helm, Managing Editor April 7, 2015
UPDATE: April 21, 2015 The Ninth Circuit announced on April 21 that St. Luke’s petition for panel rehearing and rehearing en banc were being denied after a vote of the judges. It remains to be seen whether the case will be appealed to the U.S. Supreme Court. UPDATE, April 7, 2015 Late last month, St. Luke’s and Saltzer filed a combined petition for panel rehearing and rehearing en banc with the Ninth Circuit. The providers took issue with the appellate court’s handling of the efficiencies defense, geographic markets analysis, and what they call “the …
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Illinois District Court Accepts Narrow Product Market with No Government Payers
Anne Marie Helm, Managing Editor April 3, 2015
The TakeAway On March 25, 2015, a federal district court in Illinois denied dominant provider OSF Healthcare System’s motion for judgment on the pleadings (reviewed under same standard as a motion to dismiss) in an antitrust suit filed against OSF by rival Methodist Health Services Corporation. The upshot of the opinion is that the court allowed Methodist to proceed with a product market definition that includes medical services sold to commercial health insurers, but expressly excludes the same services sold to government payers. This case importantly varies from some recent precedent …
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March Articles & Reports Roundup
Jaime S. King, Executive Editor April 1, 2015
It’s been a big month in health law! King v. Burwell was argued before the Supreme Court, the House voted to repeal the sustainable growth rate (SGR), a two-year CHIP extension was passed, and the Supreme Court held that physicians did not have the right to sue state Medicaid programs for greater reimbursements in Armstrong v. Exceptional Child Center. While you were busy reading about these and countless other developments in our ever changing healthcare system, quite a bit has been published related to healthcare prices and competition. This month’s …
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Update: Prime Backs out of Daughters Hospital Deal Due to California AG’s “Onerous” Conditions
Jaime S. King, Executive Editor and Anne Marie Helm March 10, 2015
Update (March 10, 2015): Today Prime announced that it would not go forward with its proposed acquisition of six Daughters of Charity hospitals. Prime cited the California Attorney General’s onerous conditions as its reason for backing out of the deal. Those conditions, which certainly tested Prime’s commitment to the type of acquisition and future plans for the charity hospitals that the AG’s office envisioned, are detailed below in our original post on this potential sale. The remaining challenge is for Daughters, whose future is uncertain without a purchaser to turn …
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February Articles & Reports Roundup
Jaime S. King, Executive Editor March 2, 2015
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 …
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The FTC is on a Roll with its Second Appellate Victory in Two Weeks
Anne Marie Helm, Managing Editor February 26, 2015
The FTC appears to be on a roll. On February 25, 2015, the U.S. Supreme Court affirmed the Fourth Circuit’s upholding of the Commission’s administrative ruling that the North Carolina State Board of Dental Examiners (“Board”) had illegally restrained trade under the FTC Act by forcing nondentists to cease offering teeth whitening services in that state. The underlying facts were that nondentists had been offering teeth whitening services for lower prices than were licensed dentists. In response to complaints from dentists, the Board took action to exclude nondentists from the …
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Featured Paper Review– Certificates of Public Advantage: Can They Address Provider Market Power?
Source Fellow February 19, 2015
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. …
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Updated Jan. 30: In the World of Healthcare Mergers, All Eyes Should be on Massachusetts
Jaime S. King, Executive Editor January 30, 2015
UPDATE (Jan. 30, 2015): Today, in a 48-page decision, Suffolk Superior Court Judge Sanders declined to enter the consent judgment reflecting the deal negotiated between former Massachusetts Attorney General Martha Coakley and Partners Healthcare, the Boston Globe reported today. The decision comes three days after new Attorney General filed a Notice of her office’s position on the deal, at the request of the court. That Notice raised concerns about terms of the deal, and indicated that if the court rejected the consent judgment, the A.G.’s office would void its agreement with Partners …
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