Decades of ineffective antitrust enforcement have left many US health care markets with insufficient competition to control prices. Increasingly, hospitals have merged to form dominant health systems that can exert market power and charge anticompetitive prices. This trend contributes to health care cost growth that exceeds growth in wages or the economy. Effective oversight of market conduct requires collaboration between state and federal policymakers. This brief describes actions taken by federal and state policymakers to address the consequences of health care provider concentration through increased price transparency, improved merger review, oversight of anticompetitive conduct, and increased competition through a public option.

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