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Publication Topic
Publication
January 2019 Erin C. Fuse Brown,
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 But what happens when a COPA is repealed? This issue brief looks at the COPA law in North Carolina that was enacted in 1993 and repealed in 2015.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
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
