Health Care and Life Sciences

Physician Services

Physician Services

NERA's economists frequently advise counsel on antitrust matters involving physician services, whether the issue is physician network development, physician group mergers, exclusive contracts, physician staff privileges, or monopolization. In our previous work in this area, we have:

  • Delineated the relevant geographic market for a variety of physician services, including cardiovascular surgery, obstetrics, radiology, anesthesiology, and neonatology;
  • Worked with several hospitals on antitrust issues involving physician staff privileges and exclusive contracts;
  • Assisted counsel in the defense of a rural physician network accused by the FTC of price fixing and refusing to deal with third party payers;
  • Analyzed mergers and joint ventures of IPAs and multi-specialty physician groups as well as groups of hematology-oncologists, radiologists, and anesthesiologists;
  • Assisted with the merger of a noted physician specialty group and a primary care-based Analyzed claims of anticompetitive tying where inpatient hospital services have allegedly been used to monopolize physician obstetrics, physician anesthesia, or physician outpatient radiology services;
  • Examined whether an insurer's use of exclusive contracting with a large network of primary care physicians creates a barrier to entry sufficient to keep new HMOs from entering the market;
  • Written reports assessing the competitive effects associated with IPA networks and their formation;
  • Assisted in the defense of a group of ophthalmologists that formed a network to serve managed care contracts more efficiently but ceased its referrals to one retina specialist who refused to be sub-capitated;
  • Assisted a major HMO in Colorado in its antitrust claim against an oncologist who allegedly tied the sale of cancer drugs at very high prices to his sale of physician oncology services; and
  • Testified in an antitrust case in defense of a hospital and an anesthesia group accused of conspiring to remove an anesthesiologist with quality of care problems.
Name Title Location Phone Email
Dr. Lawrence Wu President San Francisco +1 415 291 1007 lawrence.wu@nera.com
Dr. Thomas McCarthy Managing Director
Health Care Practice Chair
Los Angeles +1 213 346 3005 thomas.mccarthy@nera.com
Dr. Elizabeth Newlon Associate Director Los Angeles +1 213 346 3019 elizabeth.newlon@nera.com
Dr. Alyssa Lutz Affiliated Consultant Los Angeles +1 714 545 3000 alyssa.lutz@nera.com
Title Type Author
Paper Trail: Review of a Recent Working Paper on the Effect of Copay Coupons on Drug ... Published Article The Antitrust Source
Competition and Innovation in Health Care Markets and Their Implications for Antitrus... Published Article By Dr. Lawrence Wu with former NERA Senior Consultant Dr. Rika Mortimer
The Evidence Is In: A Review of the Market Definition Debate in Hospital Merger Cases... Published Article By Dr. Lawrence Wu
Analyzing Damages in Health Care Antitrust Cases White Paper By Dr. Thomas McCarthy with Dr. Scott Thomas