Hospital Consolidation: The Rise of Geographically Distant Mergers.

This Viewpoint discusses how and why cross-market hospital mergers are different than prototypical within-market mergers in their effects on patients and communities, why the trend may be accelerating, and future policy and research directions.

Business law issues for assisted reproductive technology practices and practitioners: considerations for sales or mergers of fertility practices.

To succeed in the assisted reproductive technology industry, physician owners of fertility practices have to develop a wide array of business skills and expertise. In today's business world, a natural next step for many assisted reproductive practices is exploring potential mergers, sales, or acquisitions. This article will explore what factors physician owners of fertility practices should consider before pursuing a potential sale or merger; how to prepare for such a transaction; and what to expect once a transaction is underway.

The Protection of Patients Under the Clayton Act.

The vast consolidation among health-care providers in the aftermath of the Affordable Care Act's enactment has led to much debate over the benefits of mergers in the health-care industry. In 2016, the Federal Trade Commission filed motions in federal court to enjoin three hospital mergers in various parts of the country. This amounted to more challenges to hospital mergers in a single year than any year in recent history. Though two of these motions succeeded at the district court level, both were overturned on appeal, which led many to wonder what the effect of these decisions would be on future health-care mergers. While many fear that hospital mergers lead to higher prices for consumers, there are also those who contend that mergers lead to efficiencies, which allow merging parties to utilize resources more effectively, increase the quality of patient care and coordination, and potentially save lives. This Note argues that the possibility of quality-enhancing or life-saving efficiencies is worth the risk that consumers see increased prices. To allow mergers that may realize these types of efficiencies, antitrust enforcement agencies and courts must begin placing greater weight on merging parties' efficiency arguments by easing the current standard. Additionally, in light of new research suggesting that cross-market health-care mergers, or mergers between providers in different geographic markets, affect bargaining dynamics between providers and insurers, this Note argues that parties' relative bargaining power must be considered in agencies' and courts' analyses of the competitive landscape relevant to a merger.

Anthem sees Trump's DOJ as its wingman.

It reads like an ugly divorce. Court records show two former partners accusing each other of lies and sabotage.

Aetna's antitrust defeat may signal the end of health insurance mega-mergers.

The Aetna-Humana antitrust ruling will complicate any deal involving health insurers with significant Medicare Advantage holdings. That combined with the uncertain future of the ACA mean the industry is likely to see a wave of smaller tie-ups.

Managing risk in today's healthcare M&A transaction.

Beyond customary business diligence, mergers in the healthcare arena must clear an array of federal and state regulatory hurdles and compliance risks that have grown more pronounced in recent years. Primary challenge are posed by: Antitrust issues. Licensing and compliance practices. Data privacy and security. Payment and revenue stability. Cultural fit and post-merger integration.

Hospital merger control in Germany, the Netherlands and England: Experiences and challenges.

Aiming at the efficiency enhancing and quality improving effects of competition, various steps have been undertaken to foster competition in hospital markets. For these mechanisms to work, robust competition policy needs to be enacted and enforced. We compare the hospital markets in Germany, the Netherlands and England regarding their experience with competition and put a special focus on merger control and the stringency of its implementation. Elaborating on the differences in merger control practice we find that despite very similar goals the respective agencies apply very different approaches and take fundamentally different routes when balancing proclaimed benefits of mergers with potential risks of consolidated markets. While the German competition authority has a strong focus on maintaining the preconditions for competition, in the Netherlands we find over the past decade a much stronger focus on hypothesized countervailing buyer power, accepting in turn highly concentrated markets. In England we find the currently most comprehensive analysis of proposed mergers in combination with a clearly positive assessment of the effects of patient choice and competition on prices and quality. All agencies are still reluctant to implement merger simulation models or similarly advanced econometric methods in their appraisal. One very likely reason is a lack of country specific empirical evidence on these matters.

Healthcare M&A: critical issues in today's fast-paced market.

In an accelerating market for healthcare mergers and acquisitions, parties to a potential deal should consider the following factors when assessing risk and reward: Economic, business, and cultural forces. Funding issues and financing structures. Potential complications during due diligence. The critical importance of effective postmerger integration. The numerous regulatory, tax, and accounting issues that can affect an acquisition.