Health Care Mergers and Acquisitions Handbook

Front Cover
American Bar Association, 2003 - Medical - 207 pages
The health care industry continues to undergo unprecedented consolidation. Health care providers and payors alike have pursued a wide variety of integrative strategies to achieve efficiencies or other business advantages. The Health Care Mergers and Acquisitions Handbook is designed to educate the practitioner about the antitrust analysis of mergers and acquisitions within the health care industry. Over the past two decades there has been an extraordinary amount of litigation related to challenges of hospital mergers. Each chapter identifies and analyzes important antitrust issues governing such consolidations. Accordingly, the first several chapters are devoted to a detailed treatment of substantive issues peculiar to such mergers: an introduction to hospital merger litigation, describing trends in litigation and the way in which such mergers are analyzed; issues unique to market definition, including product market definition and geographic market definition; the competitive effects of hospital mergers, assessing the evidence necessary to establish a prima facie case in a merger challenge and the rebuttal arguments offered by merging parties; a unique rebuttal argument offered by merging hospitals that is treated separately due to its prominent role in hospital merger litigation - the role and significance of efficiencies in determining the competitive merits of such mergers; the potential applicability of the state action doctrine to hospital mergers. In addition to a substantive treatment of hospital mergers, the Handbook also addresses; combinations of health care management organizations (HMOs) and physician practice groups; the analysis used by the enforcement agencies when reviewing mergers of HMOs; antitrust issues posed by physician practice consolidations. The appendix contains a chart summarizing litigated hospital mergers.--
 

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Contents

Merger Analysis
5
Chapter
8
E State Action Immunity Doctrine
11
Outpatient Services and the Product Market for Hospital Services
18
E Additional Market Definitions in Hospital Mergers
25
Geographic Market Issues in Hospital Mergers
31
Economic Approaches to Identifying the Relevant Geographic Market
39
Geographic Market Issues in Hospital Merger Cases
54
The Evolution of Government Policy
102
Conclusion
111
The State Action Immunity Defense
113
The Clear Articulation Requirement
119
Active State Supervision
126
E Conclusion
141
The Challenge to Aetnas Acquisition of Prudential
159
Physician Acquisitions and Mergers
169

E Conclusion
74
Government Proof of Anticompetitive Effects
80
F Conclusion
92
iii
97
Statements of Antitrust Enforcement Policy in Health Care
183
Appendix
197
Copyright

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