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Managed Care Mega Mergers, Part I: Antitrust Analysis

American Health Lawyers Association (AHLA)

Sep
20
2019

Date:

Time: 2:00PM

Topics

  • Managed Care Mega Mergers, Part I: Antitrust Analysis
     

After years of consolidation among health care providers, the industry is buzzing about two announced mega-mergers among four of the five largest health care insurers: Aetna has announced plans to acquire Humana, and Anthem has announced plans to acquire Cigna. Together, these proposed mergers total more than $90 billion and affect more than 80 million members. Stakeholders have raised a variety of policy and business rationales for and against the mergers, but antitrust clearance is a critical hurdle. This webinar will focus on the antitrust analysis of health insurance mergers, including:

  • An overview of antitrust merger law basics; 
  • U.S. Department of Justice merger enforcement in the health insurance industry;
  • Implications of new regulatory changes on the competitive analysis for health insurance mergers, including the Affordable Care Act, health insurance exchanges, and potential competition analysis;
  • How to analyze which products compete for what business (e.g., Medicare Advantage, individuals and small group, large fully insured employers, self-insured)?; 
  • In what geographic areas do competing products overlap (e.g., national market, local markets)?;
  • Potential anticompetitive effects from payer consolidation, including higher premium prices, reduced innovation, and effects on entry;
  • “Power buyers" and the potential for merged health care insurers to negotiate lower provider reimbursements;
  • Other potential efficiencies resulting from payer mergers; and 
  • What remedies are available if a payer merger poses anticompetitive concerns?

Speakers

Guest Lecturer