Healthcare Intermediaries: Competition and Healthcare Policy at Loggerheads (original) (raw)

Antitrust Concerns About Evolving Vertical Relationships in Health Care

Journal of Business Research, 2000

The greatest challenges faced by any organization are those generated The increasingly complex organizational relationships in the health-care industry are creating new management, marby a dynamic environment. Health-care organizations have faced, and keting, financial, and legal challenges. In 1993, the Federal will continue to face, significant demands imposed by changes in the Trade Commission (FTC) and Department of Justice (DOJ) practice of medicine, technology, markets, and government regulation. issued antitrust guidelines for the health-care industry (US-Provider responses to these environmental changes range from denial and DOJ/FTC, 1993). These guidelines have been updated twice opposition to the active pursuit of strategies of modification and evolution. (USDOJ/FTC, 1994, 1996), each time providing clarification Mergers, alliances, and other strategic relationships are being used to of how authorities are applying the antitrust rules within gain stronger market presence and both to meet and resist changing the health-care industry. Initially the guidelines illuminated market conditions. Because many of these relationships have potential concerns over horizontal combinations in the health-care incompetitive impacts, the level of antitrust surveillance of health-care dustry. Each revision of the guidelines has provided slightly providers has correspondingly increased. This antitrust surveillance is more guidance for health-care providers actively modifying a source of concern among health-care providers.

including © notice, is given to the source. The Industrial Organization of Health Care Markets

2014

We are grateful to editor Janet Currie for support and encouragement and to her and four anonymous referees for helpful comments that substantially improved the paper. All opinions expressed here and any errors are the sole responsibility of the authors. No endorsement or approval by any other individuals or institutions is implied or should be inferred. In particular, the views expressed in this paper are those of the authors and do not necessarily reflect the views of the Federal Trade Commission, any individual Commissioner, or the National Bureau of Economic Research. At least one co-author has disclosed a financial relationship of potential relevance for this research. Further information is available online at

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

Health Policy, 2017

People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:

The Industrial Organization of Health Care Markets

2014

The US health care sector is large and growing -health care spending in 2011 amounted to $2.7 trillion and 18% of GDP. Approximately half of health care output is allocated via markets. In this paper, we analyze the industrial organization literature on health care markets focusing on the impact of competition on price, quality and treatment decisions for health care providers and health insurers. We conclude with a discussion of research opportunities for industrial organization economists, including opportunities created by the US Patient Protection and Affordable Care Act.

Increasing consolidation in healthcare markets: what are the antitrust policy implications?

Health services research, 1998

To discuss the implications of the rapid transformation of the healthcare financing and delivery system for competition, social welfare, and antitrust policy. Horizontal and vertical consolidations can enhance efficiency but can also be anticompetitive in markets characterized by entry barriers. Active enforcement of the antitrust laws is essential to ensure that competition in healthcare markets will lead to procompetitive, rather than anticompetitive effects. However, healthcare antitrust enforcement policy must be flexible enough to allow efficient new forms of organization and practice to emerge.

Antitrust And Competition In Health Care Markets

In this chapter we review issues relating to antitrust and competition in health care markets. The chapter begins with a brief review of antitrust legislation. We then discuss whether and how health care is different from other industries in ways that might affect the optimality of competition. The chapter then focuses on the main areas in which antitrust has been applied to health care: hospital mergers, monopsony, and foreclosure. In each of these sections we review the relevant antitrust cases, discuss the issues that have arisen in those cases, and then review the relevant economics literature and suggest some new methods for analyzing these issues. JEL Codes: I11, L40, L44, L12, L13, L31, D21 1 1. Introduction The U.S. health care system is organized around markets. 1 There has, however, been ongoing concern about the functioning of these markets, so much so that some have despaired of these markets working at all. The policy response to this concern has been disjointed. Hea...

Structuring Medicaid Accountable Care Organizations to Avoid Antitrust Challenges

2012

Faced with increasingly inefficient, costly, poor quality, fragmented medical care for their citizens, several states are adopting accountable care organization (“ACO”) models of care delivery to improve access to quality health care while trying to bend the cost curve. ACOs are not one-size fits all delivery systems, however, and states are testing different models to see what works best for their needs. Some States are focusing their efforts on developing Medicaid ACOs, which may “offer a useful framework through which payers, providers, and communities can radically restructure care delivery to improve care for low-income patients and reduce system costs.” New Jersey is on the forefront of State efforts to develop safety net ACOs to provide essential health care to their most vulnerable populations. On August 18, 2011, New Jersey enacted the Medicaid Accountable Care Organization Demonstration Project. Although this pilot project shares some features with other ACOs developed at ...