Reconsidering the Ban on Physician-Owned Hospitals to Combat Consolidation

Forthcoming in N.Y.U. Journal of Legislation and Public Policy

55 Pages Posted: 11 Feb 2023 Last revised: 26 Oct 2023

See all articles by Matthew Mandelberg

Matthew Mandelberg

U.S. Department of Justice - Antitrust Division

Michael Smith

Georgetown University Law Center; Government of the United States of America - Federal Trade Commission

Jesse Ehrenfeld

Medical College of Wisconsin; American Medical Association; Vanderbilt University; Uniformed Services University of the Health Sciences

Brian Miller

Johns Hopkins University School of Medicine; Johns Hopkins Carey Business School; American Enterprise Institute

Date Written: February 5, 2023

Abstract

This paper examines hospital competition and restrictions on physician-owned hospital; it proceeds as follows. Part I provides an overview of the seemingly inexorable trends towards further consolidation among healthcare providers and the related competition concerns this consolidation raises. Part II discusses the factors which position POHs well as potential market entrants. Part III describes how the accrual of market power by incumbent hospitals and health systems accentuates the incentives and importance of physicians to identify opportunities for market entry and innovation. Part IV describes the growth of POHs and the subsequent ban on further growth and expansion. Part V then discusses the effects of the POH ban on competition in healthcare markets, potential benefits of relaxing the ban, and more narrowly tailored policy options for addressing concerns associated with physician ownership short of an outright ban. Lastly, Part VI concludes the paper with our recommendation that Congress consider removing the ban on POHs or at least relaxing it.

[Forthcoming in N.Y.U. Journal of Legislation and Public Policy]

Note:
Funding declaration: The authors received no funding for this work.

Conflict of Interests: There is no competing interest.

Keywords: antitrust law, competition policy, health policy, medicare policy, hospitals, payment policy

JEL Classification: k21, k23, j38, j41, j42, i11, i13, i18, L11, L12, L13, L25, L40, L41, L44

Suggested Citation

Mandelberg, Matthew and Smith, Michael and Ehrenfeld, Jesse and Miller, Brian, Reconsidering the Ban on Physician-Owned Hospitals to Combat Consolidation (February 5, 2023). Forthcoming in N.Y.U. Journal of Legislation and Public Policy, Available at SSRN: https://ssrn.com/abstract=4350105 or http://dx.doi.org/10.2139/ssrn.4350105

Matthew Mandelberg

U.S. Department of Justice - Antitrust Division ( email )

DC
United States

Michael Smith

Georgetown University Law Center ( email )

HOME PAGE: http://www.law.georgetown.edu/faculty/michael-h-smith/

Government of the United States of America - Federal Trade Commission

600 Pennsylvania Ave., NW
Washington, DC 20580
United States

Jesse Ehrenfeld

Medical College of Wisconsin ( email )

8701 Watertown Plank Road
Milwaukee, WI WI 53226
United States

American Medical Association ( email )

515 North State St.
Chicago, IL 60610
United States

Vanderbilt University ( email )

2301 Vanderbilt Place
Nashville, TN 37240
United States

Uniformed Services University of the Health Sciences ( email )

Brian Miller (Contact Author)

Johns Hopkins University School of Medicine ( email )

600 N Wolfe Street
Meyer 8-143
Baltimore, MD MD 21287
United States

HOME PAGE: http://www.hopkinsmedicine.org/profiles/details/brian-miller

Johns Hopkins Carey Business School ( email )

100 International Drive
Baltimore, MD 21202
United States

American Enterprise Institute ( email )

1789 Massachusetts Ave, NW
Washington, DC 20036
United States

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
653
Abstract Views
4,366
Rank
73,657
PlumX Metrics