Washington, D.C. — As consolidation and corporate ownership reshape the U.S. health care system, a new issue brief from the Center for American Progress outlines how states can use existing authority to rein in corporate power, protect competition, expand access to care, and lower health care costs for patients and families.
Hospital mergers, private equity “roll-ups” of physician practices, and vertically integrated insurers have left many communities with fewer choices, higher prices, and weakened oversight. Federal antitrust enforcement reviews only a small share of health care transactions, allowing many deals to proceed unchecked. States, however, retain broad authority to regulate health care markets and can step in where federal oversight falls short.
“Health care consolidation is not inevitable, and states are not powerless,” said Natasha Murphy, director of Health Policy at CAP and author of the brief. “States have clear policy tools to stop harmful consolidation, limit conflicts of interest, and ensure that health care markets work for patients, providers, and workers—not just corporate investors.”
The issue brief details several key policy levers available to states, including:
- Enhanced oversight of health care transactions: States can require notice and approval for mergers, acquisitions, and changes of control below federal thresholds, allowing regulators to evaluate cumulative impacts on access, affordability, and workforce conditions
- Scrutiny of private equity and roll-up strategies: By requiring disclosure of ownership structures and reviewing serial acquisitions as part of a broader pattern, states can better assess how private equity ownership affects prices, staffing, and patient care.
- Limits on corporate control of care delivery: Stronger corporate practice of medicine laws and structural separation policies can protect clinical independence and prevent self-dealing by vertically integrated corporations.
- Medical loss ratio reform: States can build on federal standards to ensure insurers spend a greater share of premium dollars on patient care, rather than profits, while improving transparency in vertically integrated insurance markets.
- Tools for price regulation and cost control: In highly concentrated markets, states can use reference-based price caps and rate review processes to curb excessive hospital prices and translate savings into lower premiums.
Read the issue brief: “How States Can Combat Health Care Consolidation and Corporate Conflicts of Interest” by Natasha Murphy
For more information or to speak with an expert, please contact Christian Unkenholz at [email protected].