Health Care

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.