Health Care Consolidation

In the first of a series of three Milbank issue briefs, Katherine L. Gudiksen, Alexandra D. Montague, and Jaime S. King of The Source for Healthcare Price and Competition describe actions taken by federal and state policymakers to address the consequences of health care provider concentration through increased price transparency, improved merger review, oversight of anticompetitive conduct, and increased competition through a public option. More

Nevertheless, with the passage of the No Surprises Act in December 2020, Congress took several steps to protect those most acutely impacted by our system’s lack of transparency and to invest in state data capacity to better understand local health care markets. More

Rob Waters explores whether the Sutter Health settlement in California can serve as a roadmap for other states looking to control rising health care prices, as well as broader efforts for reining in hospital price inflation, such as antimerger legislation and the use of state price controls. More

The pursuit of value over volume remains an epic quest in health care. Motivated to discourage overutilization of services, and by the importance of… More

The recent settlement of the antitrust lawsuits against the Sutter Health System in California could be a watershed moment in the evolution of US health care markets and public policy, says Elizabeth Mitchell, president and CEO of the Pacific Business Group on Health in a new Milbank blog post. More

To explore what employers and regulators can do about rapidly rising health provider prices and debate the most effective policies, “Los Angeles Times” journalist Noam N. Levey sat down with Dr. Robert Galvin, CEO of Equity Healthcare and an operating partner at Blackstone, and Robert Murray, the former executive director of the Maryland Health Services Cost Review Commission. More

A certificate of public advantage (COPA) is a tool used by states to permit and oversee hospital mergers that create monopoly powers. A few months ago, we published a paper about the use of a COPA in Tennessee and Virginia. But what happens when a COPA is repealed? This issue brief looks at the COPA law in North Carolina that was enacted in 1993 and repealed in 2015. It provides a cautionary tale for other states considering COPAs. More

How are states responding to the growing trend of hospital system mergers? Some 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. In effect, a COPA creates a state-monitored monopoly—or a public utility model of health care delivery. This report describes the experience of Tennessee and Virginia. More