Project Update: NASI Study Panel on Pricing Power Announces Forthcoming Papers on State Laws, Integrated Delivery Networks, and a Symposium on Antitrust Policy in Health Care

WASHINGTON, D.C. – The National Academy of Social Insurance’s (NASI) study panel on pricing power in health care markets announced a series of papers and an antitrust symposium that will address gaps in knowledge on this vital issue. The 17-member study panel has been tasked with evaluating the range of market-oriented and regulatory policy options addressing the market power of health care providers and purchasers. A final report, expected in the Fall, will explore the advantages and disadvantages of various policy options. (For details on the project see Study Panel Announced for NASI Project to Address Pricing Power in Health Care Markets.)

The study panel, co-chaired by Robert A. Berenson, M.D., of the Urban Institute and G. William Hoagland of the Bipartisan Policy Center, commissioned the following papers to be published in the Summer of 2014:

• State laws aimed at improving the competitiveness of health care markets primarily by limiting the use of certain anti-competitive contracting practices, by Suzanne Delbanco and Shaudi Bazzaz of the Catalyst for Payment Reform, and Vishaal Pegany of the Goldman School of Public Policy at the University of California, Berkeley. The paper will cover prohibitions such as “most favored nations” clauses, gag clauses that forbid disclosure of pricing information, anti-tiering clauses, and “all or none” contracting for multi-hospital systems, and will highlight innovative state actions.
• Integrated delivery networks (IDNs) will investigate vertical integration and what is known from publicly available data about the performance of large health systems. Authored by Jeff Goldsmith of Health Futures, Inc. and L. Robert Burns of the University of Pennsylvania, the paper will establish a baseline for what can be determined about IDNs from public data, and raise a host of questions about what data is needed to further assess their financial and performance efficiencies.

​The half-day symposium, Can Antitrust Policy Address Pricing Power in Health Care Markets? on May 29th in Washington, DC will feature panels on the utility of antitrust law to counter the pricing power of physicians and hospitals and the implications of public and private-sector Accountable Care Organizations for competitive markets. Participants will address the ability of antitrust law to both prevent the development of uncompetitive markets and to offer effective remedies in the case of past consolidations by either hospitals, physicians or other providers. The event is free and open to the public.

“Together, the symposium and the papers are an example of how NASI is working to advance understanding of the key issues policymakers face when they consider pricing power in the health care markets,” said Pamela Larson, Executive Vice President of NASI. “These papers will dive deeply into issues confronting the study panel. In some cases, they highlight where our current knowledge and policies fall short.”

Support for this project is provided by the Robert Wood Johnson Foundation and The California HealthCare Foundation, based in Oakland, California, and the Jayne Koskinas and Ted Giovanis Foundation for Health and Policy.

Study Panel to Address Pricing Power in Health Care Markets

​Robert Berenson, M.D., Co-Chair 
Institute Fellow, Urban Institute

G. William Hoagland, Co, Chair
Senior Vice President, The Bipartisan Policy Center

David Dranove
Walter J. McNerney Professor of Health Industry Management, Northwestern University’s Kellogg School of Management

Paul Ginsburg
President, Center for Studying Health System Change

Sherry A. Glied
Professor of Health Policy & Management, Columbia University Mailman School of Public Health

Jeff Goldsmith
President, Health Futures, Inc.

Bob Kocher, M.D.
Partner, Venrock​

William E. Kramer
Executive Director for National Health Policy,
Pacific Business Group on Health

Ronald Levy
Executive in Residence, Health Management & Policy, St. Louis University College of Public Health Social Justice

Doug P. McKeever
Chief, Health Policy Research Division, CalPERS​

Keith B. Pitts
Vice Chairman, Vanguard Health Systems

Barak D. Richman
Bartlett Professor of Law and Business Administration, Duke University

James C. Robinson
Kaiser Permanente Distinguished Professor of Health Economics at the School of Public Health, University of California, Berkeley

James Roosevelt, Jr.
President and Chief Executive Officer, Tufts Health Plan

John W. Rowe, M.D.
Professor of Health Policy and Management, Columbia University Mailman School of Public Health

Samuel O. Thier, M.D.
Professor of Medicine and Health Care Policy, Harvard Medical School

Nicholas Wolter, M.D.
Chief Executive Officer, Billings Clinic