The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
We focus on a number of topic areas identified by state health policy leaders as important to population health.
The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
Keep up with news and updates from the Milbank Memorial Fund. Get the latest from thought leaders, including Christopher F. Koller, president of the Fund.
We publish The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to population health.
News and Updates
September 26, 2018
How are states responding to the growing trend of hospital system mergers? As health care consolidation increases, policymakers have to reconcile growing evidence that most consolidations raise prices with the political pressure regulators face to approve these mergers. Several states have responded by issuing certificates of public advantage (COPAs), a legal mechanism through which they can approve mergers that reduce or eliminate competition in return for commitments to make public benefit investments and control health care cost growth.
State COPAs may be a reasonable public policy response to economic forces, but also require state regulators to take major responsibilities for ensuring they work properly.
This report, written by Erin Fuse Brown of Georgia State University College of Law, describes the experience of regulators in Tennessee and Virginia as each addressed a hospital system merger that spanned their state borders, how they worked together, the elements of each state’s COPA, and the challenges they faced. State health policymakers and other stakeholders can learn from what happened in Tennessee and Virginia, as they address future proposed hospital system mergers.
Read the report.
The Milbank Memorial Fund is an endowed operating foundation that works to improve the health of populations by connecting leaders and decision makers with the best available evidence and experience.
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