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PubMedDate not supplied

Protecting patient privacy and data quality in a community health information network.

The healthcare industry is under mounting pressure to cut costs without reducing the quality and quantity of healthcare services. One method to streamline operations is to implement community health information networks (CHINs). This article describes ways in which CHINs can offer subscribers improved efficiency, decreased costs, and improved patient care. It also addresses the fact that membership in a CHIN, if not controlled, greatly increases legal risks. Details on how many of these risks can be minimized or avoided are provided.

Antitrust Laws↗
PubMed1997

Managed care merged with the German model.

The cutbacks in Medicare and Medicaid reimbursement, and the Republican takeover of Capitol Hill and the state legislatures as a result of recent elections, suggest that the payer-driven forces of managed care, capitated payment, and the regional networks (alliances) will serve as centerpieces to improve the organization, financing, and delivery of America's health services. These "voluntary" alliances that are now being forged as an amalgam of health providers and insurance underwriters, often foreshadow the powerful, geographically linked regional health networks that are evolving into oligopolies throughout the United States. As the Department of Justice and the Federal Trade Commission are unable to appropriately analyze the efficacy of most prospective mergers, the American health field increasingly can expect monopolistic environments. In this process, the public eventually may demand the formation of state health services commissions. Within this framework, the German decentralized, multipayer, multitier approach, which historically is self-governing and allows for negotiating reimbursement rates between insurers and providers, offers a preferred option to the traditional American public utility model.

Antitrust Laws↗
PubMed1994

Hospitals and antitrust: defining markets, setting standards.

The definition of geographic and product markets is a critical aspect of any antitrust analysis. This paper argues for a different approach to market definition in areas where insurance plans that contract selectively are a significant market presence. Such a proposed approach is described and some policy implications are drawn.

Antitrust Laws↗
PubMed1995

Federal antitrust merger enforcement standards: a good fit for the hospital industry?

We examine the implications of the 1992 Horizontal Merger Guidelines for the hospital industry and subsequent policy statements that were developed for health care providers. Application of antitrust policy to hospitals has raised several concerns, mainly because many communities have few hospitals and economic forces in the industry are accelerating interest in intramarket mergers and provider network development. We address several issues, including the standing of hospitals relative to the market concentration thresholds of the merger guidelines, market concentration compared among challenged and unchallenged mergers of the 1980s, findings of previous research about the relationship between market concentration and competition in hospital markets, and differences in characteristics other than market concentration that are relevant to the merger guidelines among challenged and unchallenged mergers. We found that (1) the specific standards articulated in the merger guidelines do not provide good predictability of when a hospital merger challenge would occur, and (2) comparisons of challenged and unchallenged mergers in similarly structured markets suggest that enforcement actions may deviate in practice from the enforcement principles of the merger guidelines. We consider several options for refining antitrust enforcement policy. Refinement of enforcement policies is important given the industry restructuring that is likely through health care reform.

Antitrust Laws↗