Blame Season in the Healthcare Sector

Last week was particularly busy for AHIP. In addition to glomming onto the Express Scripts report and calling out as "fatally flawed" the AMA report, AHIP made public its November 21 amicus brief filed in the Court of Appeals for the Sixth Circuit in support of the Federal Trade Commission, which had challenged the merger of two hospitals in Ohio.

"Anticompetitive hospital mergers harm consumers by leading to higher prices and diminishing hospitals' incentives to innovate and improve quality," AHIP wrote in the brief. "Health insurance plans bring a unique and important perspective to the antitrust review of hospital mergers. They represent millions of individual consumers of healthcare and as such are a relevant customer whose insights and experiences are important to the antitrust review. Health plans have been directly affected by anticompetitive hospital mergers. It is the health plans who may be forced to accept higher prices and who may lose their ability to implement innovative approaches to improving quality."

"And of course," AHIP continued, "anticompetitive hospital mergers have also affected health plans' members. The individuals and employers who receive insurance from health plans, or who self-insure with their assistance, have seen tremendous increases in prices without corresponding increases in quality as a result of anticompetitive hospital mergers."

The federal appeals court has yet to assess blame.