A step forward for health care market oversight: Oregon Health Authority’s Health Care Market Oversight Program
- Collection:
- Health Policy and Services Research
- Author(s):
- Davison, Robin, author Gudiksen, Katherine L., author Montague, Alexandra D., author King, Jaime S., author
- Contributor(s):
- Milbank Memorial Fund, issuing body.
- Publication:
- New York, NY : Milbank Memorial Fund, March 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Antitrust Laws -- organization & administration Government Regulation Health Care Sector -- organization & administration Health Facility Merger -- legislation & jurisprudence Oregon
- Genre(s):
- Technical Report
- Abstract:
- Controlling costs and improving access, equity, and quality are critical goals for an effective and efficient health care delivery system. Consolidation has dramatically altered health care markets throughout the country in ways that limit their ability to achieve these goals. Specifically, research has repeatedly shown that consolidation leads to higher prices and reduced access to essential services. Like many other parts of the country, Oregon has experienced significant consolidation in the health care industry. Since 2020, concerns have intensified that provider financial struggles exacerbated by the COVID-19 pandemic would drive further consolidation. A recent report from the Oregon Health Authority (OHA) found that health care costs per person in Oregon grew by 49% from 2013 to 2019, faster than the national average and faster than income and inflation. The service categories that experienced the fastest increases were outpatient services, professional services, pharmacy, and emergency services. Unsurprisingly, these rising costs have resulted in Oregonians spending more of their income on health care, using savings to pay medical bills, incurring debt or medical bankruptcy, delaying medical care, or going without care altogether. Although rising costs can be attributed to a variety of factors, oversight of future consolidation is critical to any effort to protect the people of Oregon from continued cost increases that jeopardize their health and financial stability. In light of these troubling statistics, the Oregon legislature passed a law in 2021 creating a health care market oversight program and endowed the OHA with the authority to address the unchecked rise in consolidation and the downstream impacts on cost, access, equity, and quality. Although state and federal antitrust enforcement continues to be a crucial tool to combat consolidation in health care markets, the extensive time and resources needed to litigate such cases often limit its use to particularly large and egregious cases. State health care market oversight programs, like Oregon’s, can serve as important complements to antitrust enforcement as these programs can review transactions of various sizes, examine the cumulative effects of small transactions on markets, and evaluate transactions across a much wider array of factors beyond just antitrust implications. This report provides an overview of the HCMO program, including a discussion of the transactions that are subject to review, the review process, and post-transaction monitoring and compliance. It also presents the work of the program to date. Finally, the report discusses the current legal challenge to the program and offers broad considerations for other states considering implementing or strengthening policies to oversee and address health care consolidation.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (30 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918610381806676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918610381806676