A Structural Approach to Market Definition With an Application to the Hospital Industry

A Structural Approach to Market Definition With an Application to the Hospital Industry

Author: Martin Gaynor

Publisher:

Published: 2011

Total Pages: 0

ISBN-13:

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Market definition is essential to merger analysis. Because no standard approach to market definition exists, opposing parties in antitrust cases often disagree about the extent of the market. These differences have been particularly relevant in the hospital industry, where the courts have denied seven of eight merger challenges since 1994, due largely to disagreements over geographic market definition. We compare geographic markets produced using common ad hoc methodologies to a method that directly applies the "SSNIP test" to hospitals in California using a structural model. Our results suggest that previously employed methods overstate hospital demand elasticities by a factor of 2.4 to 3.4 and define larger markets than would be implied by the merger guidelines's hypothetical monopolist test. The use of these methods in differentiated product industries may lead to mistaken geographic market delineation, and was likely a contributing factor to the permissive legal environment for hospital mergers.


Getting Market Definition Right

Getting Market Definition Right

Author: Martin Gaynor

Publisher:

Published: 2017

Total Pages: 9

ISBN-13:

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In 2016 the Federal Trade Commission (“FTC”) lost motions for preliminary injunction in two separate hospital mergers. In both cases the district courts rejected the FTC's geographic market definition based on flawed interpretations of the “hypothetical monopolist” test. Fortunately, the appeals courts correctly identified the district courts' errors and reversed their decisions. In this article, we review the process used by the FTC and the Antitrust Division of the Department of Justice to define markets and discuss how this process applies to the markets for hospital services specifically. We summarize the courts' opinions in these two hospital merger cases and discuss the ways in which the district courts erred in their analyses and how the appeals courts' decisions will affect future merger cases.


Health Care Mergers and Acquisitions Handbook

Health Care Mergers and Acquisitions Handbook

Author:

Publisher: American Bar Association

Published: 2003

Total Pages: 222

ISBN-13: 9781590312230

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The health care industry continues to undergo unprecedented consolidation. Health care providers and payors alike have pursued a wide variety of integrative strategies to achieve efficiencies or other business advantages. The Health Care Mergers and Acquisitions Handbook is designed to educate the practitioner about the antitrust analysis of mergers and acquisitions within the health care industry. Over the past two decades there has been an extraordinary amount of litigation related to challenges of hospital mergers. Each chapter identifies and analyzes important antitrust issues governing such consolidations. Accordingly, the first several chapters are devoted to a detailed treatment of substantive issues peculiar to such mergers: an introduction to hospital merger litigation, describing trends in litigation and the way in which such mergers are analyzed; issues unique to market definition, including product market definition and geographic market definition; the competitive effects of hospital mergers, assessing the evidence necessary to establish a prima facie case in a merger challenge and the rebuttal arguments offered by merging parties; a unique rebuttal argument offered by merging hospitals that is treated separately due to its prominent role in hospital merger litigation - the role and significance of efficiencies in determining the competitive merits of such mergers; the potential applicability of the state action doctrine to hospital mergers. In addition to a substantive treatment of hospital mergers, the Handbook also addresses; combinations of health care management organizations (HMOs) and physician practice groups; the analysis used by the enforcement agencies when reviewing mergers of HMOs; antitrust issues posed by physician practice consolidations. The appendix contains a chart summarizing litigated hospital mergers.--


Health Care Antitrust

Health Care Antitrust

Author: Aspen Health Law Center

Publisher: Jones & Bartlett Learning

Published: 1998

Total Pages: 158

ISBN-13: 9780834212275

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Antitrust laws touch upon a wide range of conduct and business relationships in the delivery of health care services, and the issues that should be of concern to health care organizations are described. Health Care Antitrust provides practical overviews of the principal legal issues relating to health care antitrust, as well as a general understanding of antitrust analysis as applied to contractual relationships and business strategies that present antitrust risks in a managed care environment.


For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1986-01-01

Total Pages: 580

ISBN-13: 0309036437

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"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.