Monday, March 9, 2015

Flurry of Media on Competition versus Scale in US Healthcare

I was asked to give a talk later this month on "how payers think," and one key concern of payers is consolidation of the providers they must negotiate with.   This has been a longstanding policy issue in healthcare, but was accelerated by the push for larger and more integrated Accountable Care Organizations under the Affordable Care Act.

FTC-DOJ Workshop
On February 24-25, for example, the Federal Trade Commission and the Department of Justice held a joint public workshop on "Examining U.S. Healthcare Competition" -- conference announcement here, conference webpage here (agenda, materials, video).

The New England Journal ran a March 2015 article on the consolidation of providers in the Boston area, and what is, isn't, should be, shouldn't be allowed by state and federal regulators - here.  The article, by Regina Herzlinger of Harvard Business School, is titled: "Market-Based Solutions to Antitrust Threats — The Rejection of the Partners Settlement."

The CPR Group at WSJ and Health Affairs
Representing the payer (and employer) viewpoint vis-a-vis providers, the group Catalyst for Payment Reform -- CPR -- also expresses concern about provider consolidation, such as a Wall Street Journal op ed last fall about excessive consolidation among providers ("Medical Mergers are Driving Up Health Costs," here.)  The CPR group has also had several blogs in January, February, and March about value based payments to providers, rather than fee for service payments (see here, here, here.)