HLM: What should state and federal regulators be asking when they examine consolidations among providers?
Gaynor: Will it harm competition? If the answer to that is 'no' then from an antitrust perspective, you don't have a problem. If it looks like there is the potential for harm then you look at the other side: Is there a potential for benefits and are the benefits substantial enough and would they be passed on to consumers so that they would overcome any harm that would flow from the merger?
HLM: Do we need another level of bureaucracy to ensure that these regulations are coordinated and not overly burdensome and counterproductive?
Mostashari: Definitely not! Every agency that cares about and relies upon the health of markets should increasingly consider the impact on competition with consolidation.
There is a formal review process for all regulations that involve the Office of Information and Regulatory Affairs that does fine work reviewing regulations and the burden on data collection, for example, or the regulatory impact.
I don't believe competition is specifically one of the regulatory impacts considered.
Gaynor: In a sense, we are just saying 'Hey, when you're formulating rules, regulations, and policies think about their impact on competition.' Just doing that can go an awful long way.
But also, there are plenty of opportunities for communication and consultation across federal agencies, between states and the federal government. And these things happen to a large extent already. What's required is for people to be thinking about these things. But I am not suggesting more bureaucracy.
HLM: Anything else you'd like to add?
Mostashari: The United States has determined that the way we are going to deliver healthcare is through markets. This is one of those issues that is truly embraced across the political spectrum, but we have had surprisingly few actionable policy recommendations around competition in healthcare.
Competition is not just the responsibility of the Federal Trade Commission. There are many actionable policy recommendations across federal, state and private sectors that can help improve the functioning of our healthcare system for everyone.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.