March 16, 2015

In reviewing mergers of health care providers, government antitrust enforcers have historically focused on horizontal mergers between competing providers—in particular, those that result in high market shares in a specific geographic area. In the recent St. Luke’s Health case, for example, the FTC alleged that St. Luke’s purchase of a competing physician group increased its share of the market for adult primary care physicians to 80% in a suburb of Boise, Idaho.

But what about mergers between health care providers that operate in adjoining geographic markets, or between providers in the same geographic market that offer different health care services? To what extent will such cross-market mergers attract antitrust scrutiny? Recent comments by top officials at FTC and DOJ suggest that the agencies have growing concerns about cross-market transactions on the grounds that such transactions may give providers greater bargaining power in negotiations with payers.

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