The Centers for Medicare and
Medicaid Services (CMS) has been encouraging the growth of accountable
care organizations (ACOs) and other integrated models under the impetus
of the Affordable Care Act (ACA). The Federal Trade Commission (FTC),
on the other hand, remains fiercely protective of competition. If
competitors coalesce into a single large organization, there will be
fewer competitors.
The ACA provides that
“nothing [in the legislation] shall be construed to modify, impair or
supersede the operation of the antitrust laws.” In October 2011 the FTC
jointly with the Department of Justice issued its Final Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations—following, but not allaying, much criticism of the corresponding proposed rule.
The tension between the two
drives, integration versus competition, has increased steadily since the
passage of the ACA. A recent and unusual FTC decision to go to court
to block the acquisition of a medical group by a hospital...
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