Managed Care Mega Mergers, Part I: Antitrust Analysis

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?