Can provider antitrust suits against payers be successful?
In today's increasingly competitive healthcare marketplace, payers, not providers, are the driving force in the healthcare delivery system. Therefore, providers are feeling greater pressure to compete on price and other terms to become recommended providers for these payers. The question becomes: what, if any, antitrust claims does a provider have who is excluded from a payer's healthcare program, receives a lower rate of payment compared to other providers in a payer's program, or is disadvantaged by a payer's pricing decision?
D004465:Economic Competition / Q000331:legislation & jurisprudence*; D004467:Economics / Q000331:legislation & jurisprudence*; D006279:Health Maintenance Organizations / Q000331:legislation & jurisprudence*; D006761:Hospitals; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D010820:Physicians; D011243:Preferred Provider Organizations / Q000331:legislation & jurisprudence*; D011682:Purchasing, Hospital / Q000331:legislation & jurisprudence; D014481:United States; D014485:United States Federal Trade Commission