Health Care Hercules: Will Growing Provider Power Choke Reforms?
The Urban Institute - Robert Berenson, Robert Leibenluft, Robert Murray, Jordan Rau, and Steven Wartman

April, 2011

Research suggests that hospitals and physician groups, particularly through mergers, acquisitions, and consolidations, are growing ever stronger in their hometowns and beyond. Their increasing power leads to higher payment rates and premiums and could stifle efforts to contain costs and improve quality of care and efficiency. Why and how are health care providers gaining market power in their negotiations with health plans? What should be done -- or not -- to address imbalances? Is there a role for antitrust policy and enforcement? What lessons are to be gleaned from Maryland’s unique rate-setting system? Are there hidden public benefits, through education and research, that come with bulked-up market strength?

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