By: Daniel Yakoubian

Daniel Yakoubian — Wed, 12 Feb 2014 19:21:54 +0000

Excellent analysis. When advising physician groups that are not affiliated with a facility, as in a PHO arrangement, the analysis can have a very different result if the merged physician group can be replaced, or its conduct constrained, even from actual or potential competition from outside of the “market.” Especially for hospital based physicians, but also for specialists and even primary care to a degree and always depending on the facts, there is the possibility of replacement and competition from outside of the market. Because hospitals control access to many patients, and health plans do for almost all, they can recruit replacements from outside of the market by offering immediate contractual access to large groups of patients. There are physician staffing firms and other large physician groups who can take a contract and then get physicians to come in and replace the incumbents. This tends to counter the traditional local market analysis and may justify much larger physician groups than the FTC would lead you to believe is permissible. BTW – there may be a delay in getting the replacements in, but this should be acceptable under a traditional analysis – there often are switching costs and time lags due to the nature of the businesses involved.

Comments on: FTC Performs Balancing Act In Evaluating Health Care Provider Combinations

By: Daniel Yakoubian