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Hospital Mergers Promote Value and Quality

By Melinda Reid Hatton
January 10, 2017

JAMA today published the report “How Would the Next President Ensure Competitiveness in the Health Care Marketplace?” which discusses consolidation. The drive to build a continuum of care that rewards value over volume is unlikely to abate because it’s what consumers demand. Building that continuum of care requires that hospitals, physicians and other caregivers work more closely together than ever to control costs and increase quality. Rather than diminishing those goals, newer... read more

Topic: Quality and Patient Safety
Tag: consolidation

Tackling Outdated Regulatory Barriers that Impede Health Care Transformation

By Melinda Reid Hatton
July 5, 2016

A new report released today examines some of the most detrimental legal barriers that hospitals and physicians face whenever they try to work together to transform the delivery of patient care. Unquestionably, these barriers impede the hospital field’s efforts to move from a payment system based on volume to one that rewards value.  That is because the legal framework that controls the ability of hospitals and physicians to work together, and with their patients, is firmly stuck in... read more

Topic: Advocacy and Public Policy
Tags: consolidation, mergers, clinical integration, antitrust

Paper 'throws cold water' on cross-market theory of hospital merger effects

By Melinda Reid Hatton
April 7, 2016

A new paper throws cold water on an untested theory about the impact hospital realignment has on competition when the combining hospitals are far apart. The paper points out at least half a dozen possible flaws in the new theory ranging from fuzzy geographic markets to the lack of credit the authors give to increases in consumer value from realignment. The paper notes, “It is common for [hospital] systems to invest significantly to improve quality at newly acquired... read more

Topic: Advocacy and Public Policy
Tag: mergers

Consumers need Competition

By Melinda Reid Hatton
March 9, 2016

We continue to believe that the proposed deals by four large insurers is bad for consumers because it will likely result in higher premiums. Last week the AHA sent a letter to the Department of Justice that raised concerns about the proposed Anthem acquisition of Cigna focusing on the impact of Anthem’s affiliation with the Blue Cross Blue Shield System.

Despite claims that consolidation in the hospital field would be bad for health care and patients an April 2015 study by a... read more

Topic: Advocacy and Public Policy
Tags: consolidation, antitrust

Lack of Competition is Not Good For Consumers

By Melinda Reid Hatton
March 1, 2016

Today in a letter to the Department of Justice (DOJ) the AHA raised concerns about the proposed Anthem acquisition of Cigna focusing on the impact of Anthem’s affiliation with the Blue Cross Blue Shield System.

The letter states:

“Previous investigations also suggest that increased Blue plan market power will raise, not lower, premiums to consumers. We would expect that same impact on premiums in any state with a dominant or near-dominant Blue plan that gains any additional... read more

Topics: Access and Coverage, Advocacy and Public Policy
Tags: acquisitions, consolidation, mergers, access, antitrust

Flawed Paper Attempts to Link Hospital Concentration and Price

By Melinda Reid Hatton
January 8, 2016

A report released last month used commercial claims data from United Healthcare (United), Aetna and Humana to reach a number conclusions about hospital prices and concentration. The paper is badly flawed and the assertions made about hospital market structure and prices, in particular, should be viewed as unreliable for a number of reasons.  The data used are old (2008-2011) and predate the effects of public and some private payers shifting to value-based payments. Here are a few... read more

Topic: Advocacy and Public Policy
Tag: price

Study finds no systematic quantifiable relationship between price and concentration

By Melinda Reid Hatton
December 15, 2015

A new study out today conflicts head on with an April 2015 study by a leading health care expert and antitrust economist that found “concentration or structure alone is not a meaningful or reliable predictor of price changes.”  Both studies relied on commercial data, but the latter had authors who were better able to understand how the field actually functions and interpret the data accordingly.

Today’s study suffers from many deficiencies, including a lack of data from the Blue... read more

Topic: Access and Coverage
Tag: price

Aetna-Humana Merger: A Non-Stop Flight to Higher Premiums

By Melinda Reid Hatton
September 17, 2015

Insurance giant Aetna recently announced a proposal to acquire its Kentucky neighbor Humana, for $37 billion.[1] If the deal goes through, Aetna-Humana will become the nation’s largest Medicare Advantage Insurer.[2]

Among other promises, Aetna claims the deal will be good for providers and consumers because it will “strengthen the partnership between [them].” [3] Understandably, Aetna is vague on how it intends to make good on this promise of "partnership." That’s because... read more

Topic: Access and Coverage
Tags: acquisitions, consolidation, mergers, Coverage, antitrust

For Anthem Acquisition Questions Emerge About the Impact of the "Blues" Licensing Agreement

By Melinda Reid Hatton
August 24, 2015

A recent letter to the Department of Justice (DOJ) raised some new questions about how the Blues’ licensing agreement could impact the proposed Anthem/Cigna deal.  Lead counsel in a nationwide class action challenge to the licensing agreement contend that the certain provisions of that license mean that “Cigna’s effectiveness as a competitor in the market outside of Anthem’s service area will be impaired.”  They attribute this to that fact that “[e]ach Blue agrees that at least... read more

Topic: Access and Coverage
Tags: acquisitions, consolidation, access, antitrust

Mega Insurance Deals Not Good for Consumers

By Melinda Reid Hatton
August 18, 2015

The recently announced mega deals in the insurance industry will lead to further consolidation of an already highly concentrated health insurance market and will not benefit consumers says an opinion piece in Law360. The column, authored by former policy director of the Bureau of Competition at the Federal Trade Commission David Balto, concludes that these mega deals “raise profound economic and public health concerns.”

“The mergers between Aetna and Humana and Anthem and Cigna... read more

Topics: Access and Coverage, Community Health
Tags: acquisitions, mergers, Coverage, access, price, clinical integration, care coordination, antitrust
 

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