The Department of Justice is keeping an eye on potentially anti-competitive deals in the healthcare industry.
“In US antitrust enforcement and competition policy, there is no more important question than what can we do to safeguard competition in the healthcare industry,” Deputy Assistant Attorney General Andrew J. Forman said last week at a Washington, DC, conference focusing on competition in the healthcare sector. “Healthcare represents almost 20% of our GDP, and there are, unfortunately, too many competition questions that warrant scrutiny and discussion.”
Provider and payer consolidation is an area of particular focus for the Antitrust Division in connection with healthcare competition, he said at the Capitol Forum: Health Care Competition Conference.
“We are thinking about provider and payer consolidation. We wonder whether the key justification for much of this consolidation, so-called value-based care, is delivering on the promise of lower prices and improving outcomes,” Forman said.
One area of consolidation within long-term care, as McKnight’s previously reported, is CVS Health adding home care tech company Signify Health and primary care provider Oak Street Health. CVS’ new Health Services unit unifies the company’s home-based care services, primary care and retail health clinics. The company’s reorganized business also includes a Pharmacy and Consumer Wellness segment and provider-enablement capabilities.
Forman pointed to “the trend toward a more concentrated market structure with a few massive healthcare companies with robust stacks of insurance companies, providers, PBMs, pharmacies and/or other services under the same roof.”
“We wonder how this trend has impacted, or will impact, competition and power across the complex web of relationships in the healthcare ecosystem,” he said. “Is the integration, as the companies argue, a good thing? If done properly, it might be. Or has the consolidation led to … higher prices, less innovation and deeper moats defending sources of power?”
Moving forward, Forman said, healthcare companies should expect close scrutiny of potential deals that could involve antitrust issues and, “when the facts and law warrant, we will not hesitate to act.”
The Justice Department will “remain vigilant” in following up with transparency in ownership of healthcare entities, he added.
Additionally, Forman addressed labor-related issues in healthcare, such as wages disputes, noncompete and no-poach agreements and other workplace restrictions.
“In many communities across America, especially in rural America, healthcare systems are the largest employers. We must continue to be vigilant in investigating and, as appropriate, enforcing the antitrust laws around labor-related competition issues,” he said.
