A Policy and Regulatory Framework to Promote Care Delivery Redesign and Production Efficiency in Health Care Markets

TL;DR

This paper proposes a new policy framework to improve healthcare efficiency and quality by focusing on care redesign and better data collection for antitrust enforcement.

Contribution

The paper introduces a regulatory framework emphasizing production efficiency and quality over traditional market share analysis in healthcare mergers.

Findings

Current antitrust enforcement focuses too much on market share rather than production efficiency and care quality.

Improved data collection and reporting can help regulators and policymakers assess the impact of healthcare consolidation.

Longitudinal tracking of healthcare organizations is essential as they expand across markets and ownership structures.

Abstract

Policy Points
Antitrust enforcement has been too narrowly focused on predicting postmerger market share and not enough on the likely impact of mergers and acquisitions on production efficiency and quality.Care delivery redesign is a term that captures various innovations and changes in the organization and delivery of health care, which may lead to increased production efficiency and improved quality of care. Regulators and policymakers can use the framework to develop empirical measures to assist in understanding changes in production processes as well as in resultant outcomes.Significant opportunities exist to improve data collection and require reporting to better assist regulators with antitrust enforcement and help policymakers create effective legislation. Examples include improving compliance with required hospital and insurer transaction price data reporting, growing the availability of all‐payer claims databases, improving existing Medicare cost reporting, and achieving consensus on quality measures that are best used to measure the impact of consolidation.There is a fundamental need to systematically track health care organizations and their affiliations and component parts (e.g., hospitals, physician practices, skilled nursing facilities, etc.) longitudinally, especially as organizations expand across markets and state boundaries and are owned by various entities, including private equity.

Antitrust enforcement has been too narrowly focused on predicting postmerger market share and not enough on the likely impact of mergers and acquisitions on production efficiency and quality.Care delivery redesign is a term that captures various innovations and changes in the organization and delivery of health care, which may lead to increased production efficiency and improved quality of care. Regulators and policymakers can use the framework to develop empirical measures to assist in understanding changes in production processes as well as in resultant outcomes.Significant opportunities exist to improve data collection and require reporting to better assist regulators with antitrust enforcement and help policymakers create effective legislation. Examples include improving compliance with required hospital and insurer transaction price data reporting, growing the availability of all‐payer claims databases, improving existing Medicare cost reporting, and achieving consensus on quality measures that are best used to measure the impact of consolidation.There is a fundamental need to systematically track health care organizations and their affiliations and component parts (e.g., hospitals, physician practices, skilled nursing facilities, etc.) longitudinally, especially as organizations expand across markets and state boundaries and are owned by various entities, including private equity.

Antitrust enforcement has been too narrowly focused on predicting postmerger market share and not enough on the likely impact of mergers and acquisitions on production efficiency and quality.

Care delivery redesign is a term that captures various innovations and changes in the organization and delivery of health care, which may lead to increased production efficiency and improved quality of care. Regulators and policymakers can use the framework to develop empirical measures to assist in understanding changes in production processes as well as in resultant outcomes.

Significant opportunities exist to improve data collection and require reporting to better assist regulators with antitrust enforcement and help policymakers create effective legislation. Examples include improving compliance with required hospital and insurer transaction price data reporting, growing the availability of all‐payer claims databases, improving existing Medicare cost reporting, and achieving consensus on quality measures that are best used to measure the impact of consolidation.

There is a fundamental need to systematically track health care organizations and their affiliations and component parts (e.g., hospitals, physician practices, skilled nursing facilities, etc.) longitudinally, especially as organizations expand across markets and state boundaries and are owned by various entities, including private equity.

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