Clinical Integration & Antitrust

That’s the title and topic of the latest edition of the CPI Antitrust Chronicle out today.  The contents include:

  • Clinical Integration: The Balancing of Competition and Health Care Policies, Christi Braun, Ober Kaler

The antitrust agencies are unlikely to challenge a clinical integration network that is able to generate significant efficiencies that benefit consumers and about which payers do not complain.

  • Federal Courts and Enforcers Diagnose Physician Practice Associations with Risk of Conspiracy Liability: Degree of Integration is Crucial to Challenges to Medical Network Price Agreements, Heather Cooper, Sheppard Mullin

Thanks to a recent federal district court decision, physicians and medical staff have more reason to think twice about price and other arrangements adopted by the practice associations and clinics to which they belong.

  • Clinical Integration: Linchpin of Real Reform, Melinda Hatton, American Hospital Assoc.

During the year-long debate over health care reform, removing barriers to clinical integration received far less attention than it should have.

  • Are Clinically Integrated Physician Networks Candy-Coated Cartels?, Gregory Pelnar, Compass Lexecon

Are “clinically integrated” physician networks that jointly contract with third-party payors such as Blue Cross little more than “candy-coated” cartels?

  • The Interplay Between Competition and Clinical Integration: Why the Antitrust Agencies Care About Medical Care Delivery Styles, Gregory Vistnes, CRA

This discussion should help prospective ACOs understand how to pursue the benefits envisioned by the Affordable Care Act while avoiding antitrust concerns.

The Chronicle is paywalled, but I’ll report back on any of these that I find interesting.

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