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Managed Care Mega Mergers, Part I: Antitrust Analysis

American Health Lawyers Association (AHLA)

Oct
30
2015

Date: October 30, 2015

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

Professional Cropped Lomax Dionne Mintz

Dionne Lomax

Guest Lecturer

Dionne Lomax is an antitrust trial attorney with experience at the US Department of Justice. She uses that experience to represent clients facing DOJ and Federal Trade Commission scrutiny. Dionne advises Mintz clients on antitrust issues related to mergers, joint ventures, and other collaborations.