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PubMed1997

Antitrust issues for the physician organization.

This article will explore three of the most viable approaches to structuring antitrust arrangements: (1) arrangements sharing substantial financial risk; (2) arrangements that will achieve substantial clinical integration in their operations; and (3) participation in a "messenger model" physician (or multiprovider) network.

Antitrust Laws↗
PubMed1997

Santa Fe provider network goes unchallenged by the DOJ.

After careful consideration of possible anticompetitive harm and payer reaction, the Department of Justice has chosen not to challenge as unlawful a provider-controlled, nonexclusive physician network in Santa Fe, New Mexico, even though the network will include 70 percent of the area's pediatricians. Reasons for the DOJ's decision include evidence of substantial risk sharing by the physician members, an arrangement by the network to provide a different compensation system for non-member participating physicians, and the pediatricians' promise that they will participate in the network on a nonexclusive basis. In addition, the member pediatricians will be a small minority of the primary care physicians whose compensation will be paid out of one fixed revenue pool. The DOJ's decision thus signals support for a provider network model for smaller communities.

Antitrust Laws↗
PubMed1997

Who needs the middleman?

Provider-sponsored organizations say they keep third party players from meddling in the doctor-patient relationship. While their viability is uncertain, their focus on quality is raising the competitive stakes.

Antitrust Laws↗
PubMed1997

FTC and DOJ modify efficiency provisions of merger guidelines.

Revisions to the Merger Guidelines issued by the Federal Trade Commission and Department of Justice may indicate some easing of Federal antitrust enforcement practices of the past. The revisions clarify how claims that mergers are likely to lower costs, improve quality, or otherwise achieve efficiencies are analyzed. The revisions provide guidance to potential merger partners about which efficiency claims might be scrutinized. The guidelines should be considered in their entirety when mergers are being considered; however, these revisions may indicate increased flexibility in the types of transactions that will be allowed.

Antitrust Laws↗