http://www.beckershospitalreview.com/lists/15-largest-health-systems-in-the-u-s-june15.html
Tag Archives: Market Power
Appeals court blocks Penn State Hershey Medical Center-PinnacleHealth merger
A federal appeals court has reversed a lower court ruling and ordered a preliminary injunction against the proposed Penn State Hershey Medical Center-PinnacleHealth System system merger.
The 3rd U.S. Circuit Court of Appeals in Philadelphia voted in favor of the injunction, which reversed a May decision by a federal judge, saying the U.S. Federal Trade Commission and Pennsylvania officials would likely be successful in showing the merger could cause price hikes for patients and would harm competition, according to the decision.
The injunction will allow the FTC to further review the proposed merger, would mean the combined system would garner support 76 percent of the population around Harrisburg.
AMA: Insurance megamergers ‘threaten healthcare access, quality and affordability’
- The merger of health insurance giants “would significantly compromise market competition in the health insurance industry and threaten health care access, quality and affordability,” the president of the AMA said as the group released new analyses of the mergers.
- In the analysis, the AMA claims the Anthem-Cigna merger would diminish competition in 121 metro areas across 14 states, and that the Aetna-Humana merger would diminish it in 51 metro areas across 15 states.
- The studies also note an “unprecedented lack of competition” that already exists in many states, the AMA says.
http://www.ama-assn.org/ama/pub/news/news/2016/2016-09-21-ama-analyses-support-blocking-mergers.page
The Missing Debate Over Rising Health-Care Deductibles
Progressives push for ‘public option’ health plan
http://www.usatoday.com/story/news/2016/09/15/progressives-push-public-option-health-plan/90375964/
Progressive senators and activists are launching a campaign Thursday calling for every American to have the choice of a public health insurance option.
Four Delaware health systems form new alliance
The new eBrightHealth is a partnership of Christiana Care Health System, Bayhealth Medical Center, Beebe Healthcare and Nanticoke Health Services
EBrightHealth dovetails with the health care reform the state is undertaking with the Delaware Center for Health Innovation, officials say. It also builds on the relationships the systems have established over the last year as they participate in the statewide Quality Partners Accountable Care Organization.
The ACO focuses on creating more comprehensive care and cost-savings for Medicare patients. As Nevin said, it’s designed to reward hospitals for disrupting their business model by encouraging them to find ways to keep people healthier so they don’t need emergency rooms or hospital admission.
Christiana Care’s Care Link program is an example of what has come out of the ACO. Carelink identifies complex patients who are high-risk, for example those who do not have access to primary care, and connects them to physicians who will reach out and find out what their needs are.
Social workers, pharmacists, behavioral health therapists and nurses are all involved.
EBrightHealth is modeled after initiatives such as AllSpire Health Partners, which is a consortium of seven New Jersey and Pennsylvania hospital systems. That organization is three years old.
Cost Control Efforts Working ‘So Far’ in MA
Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won’t tolerate any more cost shifting.
Each year, we put together a cost trend report that outlines what forces are at play in the state in terms of raising spending and we have hearings every October. We are trying to play an interesting role which is not be regulatory, but really to be in the face of the healthcare system in terms of saying, “Hey be careful. Don’t go the extra mile on in spending or pricing.”
We want to do it in a way that doesn’t destroy or even hurt the health system. In any attempt to do that, some of the forces within the health industry scream.
But, for the most part, the hospitals have been supportive of our efforts. If we were to squeeze too hard, they would react more negatively. Everyone is engaged in a very interesting balancing act. We are trying getting the system to work more efficiently… and they are trying to control costs without destroying themselves. So far it’s working.
Aetna faces probe over ‘politically motivated’ Obamacare exit
- A group of senators is seeking answers from Aetna about its abrupt decision to leave the ACA marketplaces following the DOJ’s challenge to the company’s proposed $37 billion merger with Humana.
- The letter came Thursday from Senators Elizabeth Warren (D-Mass.), Bernie Sanders (I-Vt.), Edward J. Markey (D-Mass.), Sherrod Brown (D-Ohio), and Bill Nelson (D-Fla.).
- While other insurers have also scaled back their ACA participation, the probe into Aetna comes in response to a letter from Aetna CEO Mark Bertolini in which the company is perceived to have directly threatened the government that it would leave the exchanges if the merger was not approved.
Aetna’s Bertolini counters accusation of power play against DOJ
http://www.courant.com/news/connecticut/hc-bertolini-senators-20160912-story.html
- Aetna CEO Mark Bertolini has responded to a letter from a group of senators who accused the company last week of exiting the majority of its ACA markets as a ploy against the federal government for challenging Aetna’s proposed merger with Humana.
- Bertolini dismissed the senators’ arguments as”unfounded accusations,” the Hartford Courant reported.
- Aetna spokesman T.J. Crawford told the Courant the company had not received a response from the senators.
Ascension’s expansion efforts pay off as operating surplus swells to $753M
Click to access ES819017-ES642670-.pdf
St. Louis-based Ascension reported $21.9 billion in revenue in fiscal year 2015, up 6.6 percent from revenue of $20.5 billion in the year prior, according to financial documents filed with bondholders.
The financial boost was partially attributable to an increase in patient volume due to Ascension’s expansion efforts in the past year. During the year ended June 30, 2016, Ascension acquired Glendale, Wis.-based Wheaton Franciscan Healthcare and added hospitals in Michigan and Tennessee as well.
Including these recently acquired facilities, the nonprofit system said inpatient admissions and inpatient surgeries increased 3.2 percent and 3.3 percent, respectively, as compared to the year prior. Ascension also said emergency room visits increased 3.7 percent year over year.
After accounting for a year-over-year increase in expenses of 6.1 percent, Ascension ended FY 2015 with an operating surplus of $753.2 million, up from $696.5 million in the year prior.
HENRY KOTULA 