Antitrust Law Daily Wrap Up, ANTITRUST NEWS: FTC to continue “scalpel-like” approach to health care enforcement, (Jun 18, 2015)
Organizations Mentioned:Centers for Medicare & Medicaid Services | Federal Trade Commission
By Greg Hammond, J.D.
Speaking at the Sixth Annual Accountable Care Organization Summit Preconference in Washington, D.C., on June 17, 2015, FTC Commissioner Julie Brill noted that the federal antitrust agencies have not yet challenged a single Accountable Care Organization (ACO) as anticompetitive. In her prepared keynote address, entitled “A Common Goal: The U.S. Federal Trade Commission’s Healthcare Enforcement Program and Its Implications for ACOs,” Commissioner Brill stated that the Commission will continue its scalpel-like approach to antitrust enforcement, targeting only those few combinations that raise serious competition concerns.
“[W]ith the passage of the Affordable Care Act, there is renewed focus not only on containing costs, but also on promoting quality improvements for millions of U.S. healthcare consumers,” Brill said. “Concurrently, we are seeing a wave of mergers, ACOs, and other collaborations—not only among competing health care providers, but also among hospitals and physicians, as well as between health systems and health plans.”
To date, providers have created 405 ACOs, including 89 new Shared Savings ACOs in 2015, Brill revealed—representing 7.2 million assigned beneficiaries in 47 states, Washington, D.C., and Puerto Rico. Early data showed that these ACOs experienced cost and quality improvements as a whole. In particular, Commissioner Brill noted a Centers for Medicare & Medicaid Services (CMS) study reporting that Shared Savings Program ACOs improved on 30 of 33 quality measurements. Another study, reported in the New England Journal of Medicine, found that Year 1 of the Pioneer ACO program was associated with modest reductions in Medicare spending.
“CMS and the antitrust agencies are aligned in the belief that competition is good for healthcare consumers, including competition among ACOs,” Brill stated. However, the FTC’s enforcement actions to date have mostly focused on mergers and price fixing by unaffiliated providers, not ACOs, Brill said, as the FTC has not received a single complaint warranting further antitrust scrutiny.
Nevertheless, the Commission will continue to provide industry players with guidance on how to form procompetitive or competitively-neutral ACOs, Brill assured. The FTC will also be available on a voluntary basis to advise ACOs of antitrust risk.
“We will continue to coordinate with CMS and other organizations to ensure that antitrust is working in tandem with health policy efforts to promote high-quality, affordable health care,” Brill said. “CMS consults with the FTC on development of new ACO models, as well. We will continue to meet with, and bring together various stakeholders in healthcare to discuss shared challenges and experiences.”
News: Antitrust FederalTradeCommissionNews