The U.S.’s pursuit of lower health care costs and higher quality health care services has included the incentivizing of new organizational structures and payment models that trigger long standing concerns about maintaining competition in the health care system. As a result of these developments, the Federal Trade Commission and the U.S. Department of Justice is hosting its second “Examining Health Care Competition” public workshop. The workshop could not be more timely: earlier this month, the Ninth Circuit Court of Appeals affirmed a district court’s ruling that the merger of St. Luke’s Health Systems, Ltd. and Saltzer Medical Group violated Section 7 of the Clayton Act, agreeing with the district court that the anticompetitive effects outweighed the potential efficiencies of the merger.
The workshop began yesterday and continues through this evening. It will be exploring five main themes:
- early observations regarding accountable care organizations;
- alternatives to traditional fee-for-service payment models;
- trends in provider consolidation;
- trends in provider network and benefit design strategies; and
- early observations regarding health insurance exchanges.