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Publication Topic
Publication
September 2018 Erin C. Fuse Brown,
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
