Health Care

Hospital Services

NERA's health economists have been retained to evaluate the likely competitive effects of a variety of matters involving hospital services. For example, over the past several years, NERA has analyzed over 75 hospital mergers and provided strategic advice on choosing merger partners in many more.
 
In addition, NERA also has substantial expertise in evaluating allegations involving attempted monopolization, tying and bundling, exclusive contracts, and exclusive dealing cases by hospitals. Our experience spans a broad range, from analyses prepared for the Federal Trade Commission and the US Department of Justice to studies and testimony presented in connection with Certificate of Public Advantage hearings or litigation in connection with state Certificate of Need reviews.
 
A sampling of our projects include:

• Analyzed horizontal mergers involving freestanding hospitals, acquisitions involving hospital chains, and the formation of hospital networks, joint ventures, joint operating agreements, and strategic alliances;
• Frequently presented the results of our analyses to staff attorneys and economists at the Federal Trade Commission, the Department of Justice, state attorneys general, and state departments of insurance;
• Written reports that assess the likely efficiencies associated with horizontal integration and with vertical integration between health insurers, hospitals, and physician groups;
• Advised state agencies on the types of hospital mergers that could be permitted under their certificate of public advantage legislation and on the type of monitoring and regulation that would be required postmerger;
• Assisted in the defense of a hospital accused of monopoly overcharges by demonstrating that its pricing structure and price increases over time have been well within the mainstream of comparable hospitals;
• Testified on behalf of hospitals in antitrust litigation involving staff privileges or exclusive contracting issues for anesthesia, neonatology, vascular surgery, cardiac surgery, obstetrics, radiology, and cardiology specialists;
• Written numerous papers on hospital antitrust issues including merger efficiencies, geographic markets, and hospital merger policy;
• Analyzed patient migration patterns to determine whether a Catholic hospital's religious directives caused problems with access to women's reproductive services following a merger; and
• Analyzed the competitive effects of joint ventures among hospitals to sell a broad geographic network product to statewide and regional insurers.