Legally speaking: Federal Trade Commission issues positive advisory opinions on antitrust implications of clinical integration.
From time to time, groups of physicians in an area may determine that they would benefit from "integrating" their practices into an IPA, PHO, or other joint venture. The anticipated benefits may include economies of scale, the ability to coordinate care between primary care physicians and specialists, providing disease management services for patients with certain conditions, or a myriad of other reasons. A key characteristic of these proposed integrated models is the ability for the group as a whole to negotiate with insurance companies and self-funded health care plans. When a group reaches the point of negotiating collectively for the fees that a pay- or is going to pay for various services throughout the plan, possible antitrust implications arise.
Wright
Robert
R
Mitchell Blackstock Law Firm, USA. MBHealthLawDivision@mitchellblackstock.com
D016363:Antitrust Laws; D001131:Arkansas; D019033:Delivery of Health Care, Integrated / Q000331:legislation & jurisprudence*; D004465:Economic Competition / Q000331:legislation & jurisprudence*; D006759:Hospital-Physician Joint Ventures / Q000331:legislation & jurisprudence*; D006801:Humans; D014481:United States; D014485:United States Federal Trade Commission / Q000331:legislation & jurisprudence*