HEALTHCARE MARKETS
The Source Roundup: July 2023 Edition
Mary Mitchell, Student Fellow July 3, 2023
Summer is here, and we hope you can enjoy some vacation time. Whether you’re at work or on the beach, our July roundup brings you the highlights of recent healthcare pricing and competition studies and reports. First, we share several articles that discuss the potential for anticompetitive impacts from consolidation through collaborative agreements and cross-market mergers, two types of lesser-examined transactions that more easily escape regulatory scrutiny. Next, we share an American Hospital Association fact sheet that spotlights insurer policies and acquisitions as under recognized contributors to the changing landscape …
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Governor Newsom’s May Revision to California 2023-2024 State Budget
Mary Mitchell, Student Fellow June 14, 2023
On May 12, California Governor Gavin Newsom released the May Revision to his January proposal for California’s 2023-2024 budget. The so-called “May Revise” lays out a $306.5 billion budget for total state funds,[1] up from $296.9 billion in January’s proposal.[2] The higher budget also includes a higher deficit due to unexpectedly low tax revenues:[3] the plan now anticipates a $31.5 billion shortfall,[4] about $10 billion more than predicted in January.[5] Despite the deficit, the revised budget proposal avoids cuts for core health programs and services,[6] as the Governor continues to …
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The Source Roundup: June 2023 Edition
Stephen Cosenza, Student Fellow June 1, 2023
In the past month, newly released publications have chronicled how partnerships, alternative payment models, and insurer market power affect competition and consolidation. Separately, researchers examined Affordable Care Act developments in terms of its impact on coverage and costs of health care. Moreover, as more and more price data are made publicly available, researchers studied how that data is presented, utilized, and what is reveals. Competition and Consolidation Since 2005, over 190 rural hospitals have closed across the US, and today, 600 more (the nearly one third that remain) are …
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FTC Challenges Antitrust Immunity Under Louisiana COPA
Amy Y. Gu, Managing Editor May 15, 2023
The healthcare market is seeing intense antitrust scrutiny in recent years at both the federal and state level. As the Federal Trade Commission (FTC) and Department of Justice (DOJ) step up their enforcement efforts, some states are exploring avenues to allow healthcare entities to pursue consolidating transactions the state deems beneficial and avoid antitrust challenge. One of them is the use of certificate of public advantages (COPA). A recent slew of antitrust immunity disputes coming out of a healthcare merger in Louisiana brought the use of COPA and state action …
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2023 California Healthcare Bills Part 1: Healthcare Consolidation and Competition
Rachel Ng, Student Fellow May 11, 2023
In the 2023-2024 legislative term, the California legislature has introduced a multitude of legislation targeting consolidation and competition in health care, system reform and price and quality transparency. In a two-part series, we highlight some of the noteworthy legislation proposed this session. Part 1 focuses specifically on the State’s efforts to promote a more competitive healthcare market by targeting restraints of trade and consolidation. In Part 2, the focus will shift to proposed bills targeting system reform, price and quality transparency, and prescription drug prices. Health Care Consolidation California …
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The Source Roundup: May 2023 Edition
Rachel Ng, Student Fellow May 1, 2023
As we prepare to transition to the summer, this month is an opportune time to examine the impacts of potentially a new season in the health care market. Researchers noted that not only is there a rise of geographically distant mergers even as rural hospitals struggle to maintain profitability, but also that private equity is a new major financier of the health care market. On the other hand, California hopes to increase competition with Golden Choice, a state-run public option. Federally, price transparency efforts could be a step towards creating …
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FTC Shows Aggressive Enforcement Agenda in Decision to Unwind Vertical Merger in Healthcare Technology
Amy Y. Gu, Managing Editor April 17, 2023
The federal agencies have been flexing their muscles in antitrust enforcement in recent years to reinvigorate competition. This month, the Federal Trade Commission (FTC) ordered the unwinding of a completed merger that combined gene sequencing company Illumina and cancer test developer Grail. This move is highly unusual not only because of the vertical nature of the consolidation, which typically receives less antitrust scrutiny, but also how the Commission unanimously voted to undo a consummated merger while overturning an administrative court ruling in the process. For these reasons, this latest development …
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The Source Roundup: April 2023 Edition
Rachel Ng, Student Fellow April 3, 2023
With the healthcare market at the most consolidated it has ever been, both federal and state action is needed to ensure health care systems provide high-quality, affordable care that is accessible. In this month’s roundup, we begin with several publications authored by The Source team on the ramifications of consolidation and the role of federal and state antitrust enforcers. Researchers also considered whether health care providers and insurers have returned to pre-pandemic performance levels. With the rise of health care spending and health care costs, understanding these trends becomes especially …
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The Source Founder Jaime King Discusses The Trials and Triumphs of Health Care Antitrust Law on NEJM
Amy Y. Gu, Managing Editor March 23, 2023
In a New England Journal of Medicine article and accompanying interview, The Source Founder and Distinguished Fellow Jaime S. King provides an overview of the history of healthcare antitrust law and enforcement and discusses the functions of antitrust law and the effects of health care consolidation on prices, quality of care, and access to care. The perspective piece asserts that combining competitive and regulatory forces may offer the only hope for controlling health care prices, restoring high-quality care, protecting health care workers, and preserving and expanding access to care. Check out …
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Revolutionizing Medi-Cal: The Potential Impact of California’s CalAIM Initiative
Rachel Ng, Student Fellow March 15, 2023
California’s Medi-Cal program is the largest Medicaid program in the country. It is tasked with providing care for approximately 15 million enrollees, or one third of California’s population. To ensure affordability while maintaining quality and improving health care outcomes, CalAIM was created as California’s newest approach to reform Medi-Cal, including changes to managed care plans and reimbursement of behavioral health plans. Although many of these objectives under CalAIM are still in the initial implementation stages, the potential ramifications of this multi-year, billion-dollar investment in changing how millions of people receive …
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