I predict this will pass antitrust scrutiny from both the feds and the state:
- While this is a large merger (about 1,100 doctors with nearly a million patients), size alone isn’t determinative.
- These cases are won or lost on market definition and Atrius and the Fallon Clinic are in different geographic markets: Boston & Worcester. The vast majority of the Atrius doctors are inside I-495 and most are inside Route 128. The geographic center for Fallon is Worcester. These are distinct primary care markets.
- While the plans currently compete in the I-495/I-90 corridor (Framingham, Marlborough, Milford, Westborough and Harvard), this is a relatively small part of their revenues.
- Scale and scope efficiencies are plausible.
- They will play the ACO quality card. We’ve blogged on this quite a bit.
One caveat: if the hospitals (Partners) or health plans (BCBS-MA) strongly opposed the merger, then all bets are off. But I don’t think Blue Cross will oppose the merger:
“We need to keep a balance of power in this state between physicians and hospitals,’’ said a senior health insurance executive who did not want to be identified to avoid antagonizing business partners.
“If we have a strong Atrius, we can keep some of the hospitals in check. I worry that too many physicians are becoming employees of hospitals. [Hospitals] are doing it because they want to control referrals — I get it — but it’s not healthy.’’
Nor is it likely that Partners will want to anger Atrius with an antitrust challenge.
*If this were really legal advice, I’d send you a bill.