Report Release

Soaring Private Equity Investment in the Healthcare Sector: Consolidation Accelerated, Competition Undermined, and Patients at Risk

By Richard M. Scheffler, Laura M. Alexander, and James R. Godwin | Published May 18, 2021 | Press Release | Link to Full Report

A decade’s worth of evidence supports troubling findings that private equity business practices have a negative impact on competition in healthcare and on patients. A new white paper, produced by experts at UC Berkeley and the American Antitrust Institute (AAI), calls for immediate attention to the role that private equity investment plays in harming patients and impairing the functioning of the healthcare industry. In this groundbreaking new white paper, Soaring Private Equity Investment in the Healthcare Sector: Consolidation Accelerated, Competition Undermined, and Patients at Risk, AAI’s Laura Alexander and Professor Richard Scheffler of The Nicholas C. Petris Center on Health Care Markets and Consumer Welfare in the School of Public Health at UC Berkeley detail the emerging threat posed by private equity investment in healthcare markets.

The report details and measures private equity trends for the overall healthcare sector and provides a deep dive into four particular areas: hospitals and inpatient services, clinics and outpatient services, elderly and disabled care, and pharmaceuticals. However, the data do not tell the complete story. Several concerns are analyzed by presenting case studies of private equity involvement in healthcare and reporting evidence on the impact private equity investment has had on health and quality. Drawing on these data and examples, the major threats and risks to competition posed by the injection of private equity business practices into healthcare markets are identified and analyzed. The report summarizes what state and federal legislators have done to address the financial impacts of such behavior and presents suggested actions and potential policy solutions.

Petris Center Cited in Report by Healthy California for All Commission Cites

Healthy California for All Commission released a report, “An Environmental Analysis of Health Care Delivery, Coverage, and Financing in California” for California Governor Gavin Newsom, Senator Richard Pan, and California State Assemblymember Jim Wood. It examines the strengths and limitations of California’s current health care system, outlines potential designs to transition to unified financing, and describes health coverage expansion options.

In its analysis of provider consolidation, The Petris Center’s study “The Sky’s the Limit” is cited for trends of hospital market concentration. “A New Vision for California’s Healthcare system” is cited in discussing cost containment strategies, and “California Dreamin’: Integrating Health Care, Containing Costs, and Financing Universal” explores the role of integrated plans.

The Source Publishes Report “Preventing Anticompetitive Contracting Practices in Healthcare Markets”

This research report titled “Preventing Anticompetitive Contracting Practices in Healthcare Markets” analyzes five specific clauses in healthcare contracts that have the potential for anticompetitive harm. In understanding the theory and empirics of pro- and anti-competitive effects in specific healthcare markets, we reviewed legal and economic literature, examined antitrust enforcement of contract terms, and surveyed all 50 states of proposed and enacted legislation restricting the use of these contract clauses. This report is the latest product from a joint project with The Petris Center and The Source on Healthcare Price and Competition supported by Arnold Ventures.

This project leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider and insurer markets in the United States in the last ten years and presents evidence-based information and analyses on the most effective strategies for states to address rapidly consolidating healthcare markets. In the first published report in the series, “Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States” identifies best practices that state policymakers should consider to enhance oversight of healthcare consolidation in their own state.

Additional research findings and analyses are published on the “Provider Contracts” and “Market Consolidation” key issue pages.

The Source Publishes Report Titled “Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States”

In the newly released research report “Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States,” The Source on Healthcare Price and Competition identifies best practices that state policymakers should consider to enhance oversight of healthcare consolidation in their own state. This report is part of a joint project with the Petris Center supported by Arnold Ventures.

This research report is the latest installment in a collaborative research series that leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider and insurer markets in the United States in the last ten years and presents evidence-based information and analyses on the most effective strategies for states to address rapidly consolidating healthcare markets. Additional research findings and analyses are published on the “Market Consolidation” key issue page on The Source’s website.

 

“Implementing Population Health In The US: Lessons From Spain” published in Health Affairs blog

On July 9, 2019, Health Affairs published a blog post written by Roberto Nuño-Solinís, Stephen Shortell, Richard Scheffler, and Meg Kellogg. The post underscores strategies for better achieving population health in the US based off of the Basque region’s successful implementation of specific programs. These include consumer engagement, the development of IHOs, an emphasis on prevention, a broad-based integrated personal health record, and an effort toward cross-sector funding. The post concludes that “these are important lessons for the US, but ongoing evaluation of population health initiatives in all countries is needed to enhance the learning that can contribute to better health.”

To read to full blog post, click here

Petris Center Blog Post published in Health Affairs

On June 26. 2019, Health Affairs published a blog post written by Steve Shortell, Richard Scheffler, Shivi Anand, and Daniel Arnold. The post highlights California’s experience with integrated delivery systems—specifically, integrated care model physician organizations; provides new evidence on their ability to provide lower-cost, higher-quality, value-based care; and, proposes a plan by which a state could expand such models to meet the needs of increasing numbers of people who would gain access to care under universal coverage. 

To read the full post, click here.

Dr. Scheffler Showcases Petris Report in Santa Monica Forum: Health and Health Care in California

In September, Petris Center Director Dr. Richard Scheffler was able to present at a Health Affairs forum located at the RAND Corporation’s Santa Monica Headquarters in Los Angeles. The day-long event featured a variety of related topics including hospital consolidation, universal health care, and diversity disparities in care. California Health Secretary Michael Wilkening presented opening remarks, followed by a series of presenters including Dr. Scheffler, who showcased the Petris Center report “Consolidation Trends In California: Impacts On ACA Premiums And Physician Prices For Outpatient Services.”

Watch the webcast of the full forum here.

A more detailed list of topics and attendees can be found here.

Read the full Petris report through Health Affairs here.

Fulton, Arnold, and Scheffler Publish New Commonwealth Fund Blog: “Market Concentration Variation of Health Care Providers and Health Insurers in the United States”

Today, the Commonwealth Fund published a new To The Point Blog by the Petris Center’s Brent Fulton, Daniel Arnold, and Richard Scheffler. The blog, titled, “Market Concentration Variation of Health Care Providers and Health Insurers in the United States”, discusses the variability of health care concentration in the United States by MSA and what it means for state and federal regulation.

You can read the full blog on the Commonwealth Fund’s website here.

To learn more about the Petris Center’s market concentration research supported by the Commonwealth Fund, see our project page here.

New Health Affairs Blog from the Petris Center – Financing Universal Coverage In California: A Berkeley Forum Roadmap

Today, Health Affairs published a new blog by Petris Center researchers, entitled “Financing Universal Coverage In California: A Berkeley Forum Roadmap.” The blog provides updated estimates of health spending in California under the status quo for the period 2015 through 2022, and of the potential expenditure reductions from implementing the three Berkeley Forum cost-saving initiatives – global budgets/integrated care systems, patient-centered medical homes, and palliative care – for the period 2018 through 2022. The blog shows that if California were able to capture these spending reductions, they could be used to finance health coverage for the remaining uninsured Californians.

You can read the full blog on the Health Affairs website here.

The blog is a companion piece to the Petris Center report “Proposal to Use Three Initiatives to Lower Healthcare Spending and Finance Universal Health Insurance Coverage in California.” You can read the full report here.

Just Released Petris Report: Proposal to Use Three Initiatives to Lower Healthcare Spending and Finance Universal Health Insurance Coverage in California

The Petris Center has released a new report, “Proposal to Use Three Initiatives to Lower Healthcare Spending and Finance Universal Health Insurance Coverage in California,” authored by Petris Center Director Dr. Richard Scheffler, Associated Director Dr. Brent Fulton, Petris Research Associate Donald Hoang, and Dr. Stephen Shortell.  Health expenditures in California continue to grow with respect to the state’s gross domestic product, resulting in healthcare becoming more unaffordable to the state, employers, and individuals. In this report, the authors project health spending in the California from 2015 to 2022. They then estimate potential reductions in spending from the Berkeley Forum for Improving California’s Healthcare Delivery System’s initiatives to increase the use of global budgets/integrated care systems, patient-centered medical homes, and palliative care. By 2022, these initiatives generate an estimated $15.4 billion in health spending reductions, an amount sufficient to provide universal health insurance coverage in the state at a cost of $7.2 billion. The State of California, the federal government, and the private sector should consider accelerating their programs related to these initiatives to help achieve these health expenditure reductions.

A companion article “Financing Universal Coverage in California: A Berkeley Forum Roadmap” to this report was published on the Health Affairs Blog on March 29, 2018. You can read the blog post on the Health Affairs website here.

You can read the full report here.