The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
April 12, 2021
News Article
Rachel Block
Jun 16, 2026
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States are increasingly facing difficult questions about how to respond to health care consolidation, particularly mergers of health care organizations. Evidence shows that increased consolidation reduces competition and can increase costs. In addition, states may want to prevent their local health care systems from merging with out-of-state organizations, which they are less able to regulate. This may be a particular concern if the local entity is non-profit — and subject to community benefit requirements — and the out-of-state entity is a for-profit; such a merger could lead to fewer population health investments and less local accountability.
Consistent with the Milbank Memorial Fund’s mission to provide policymakers with the best evidence and experience, we offer technical assistance to state officials as they navigate these complex issues. To that end, we recently commissioned Jaime King of the University of Auckland, Robert Berenson of the Urban Institute, Robert Murray of Global Health Payment, and Katherine Gudiksen of The Source on Healthcare Price and Competition to provide state officials in Rhode Island with an in-depth legal and policy analysis of health system consolidation in their state and the impact of a potential merger between the health systems Lifespan and Care New England.
A recent presentation by these researchers offers an overview of the state and local markets, factors that the Federal Trade Commission (FTC) considers when analyzing proposed mergers, and the state’s policy options. The policy options include two paths: the first involves cooperating with the FTC, and the second involves acting independently by challenging the merger or establishing a certificate of public advantage (COPA). We are pleased to share these resources with other states that may be facing similar circumstances.
Read the presentation