Will ACOs Face Tough Antitrust Scrutiny?

For some reason, I’ve always been interested in antitrust regulation, not just in the healthcare industry but across the board. To me, there’s something fascinating about how federal agencies define markets, figure out what constitutes an unfair level of market dominance and decide which deals are out of bounds. For someone who’s not a lawyer, perhaps that’s a strange sort of geeking out to do, but there you have it. Obviously, given how complex industry relationships are, healthcare relationships are fraught with antitrust issues to ponder. Lately, I’ve begun thinking about how antitrust regulators will look at large ACOs. And I’ve concluded that ACOs will be on the radar of the FTC and U.S. Department of Justice very soon, if they aren’t already. On their face, ACOs try to dominate markets, so there’s plenty of potential for them to tip the scales too far in their favor for regulators to ignore. Their business model involves both vertical and horizontal integration, either of which could be seen as giving participants too much power. Please take the following as a guide from an amateur who follows antitrust issues. Again, IANAL, but my understanding is as follows: Vertical integration in healthcare glues together related entities that serve each other directly, such as health plans, hospitals, physician groups and skilled nursing facilities. Horizontal integration connects mutually interested service providers, including competitors such as ...
Source: EMR and HIPAA - Category: Information Technology Authors: Tags: ACO EHR Electronic Health Record Electronic Medical Record EMR Healthcare Healthcare Business Hospital EHR Hospitals FTC Health Insurers Health Plans Healthcare Antitrust Healthcare Law Healthcare Regulation US Department of Source Type: blogs