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AHA urges House panel to address barriers to clinical integration

May 18, 2012

Mergers and acquisitions are often the preferred way to build a continuum of care to replace the current fragmented system of health care because regulatory barriers favor consolidation over clinical integration, AHA said in a statement submitted today to a House Judiciary subcommittee hearing on health care consolidation and competition after the Patient Protection and Affordable Care Act. "Antitrust laws, outdated fraud and abuse policies and even tax-exempt rulings favor consolidation over clinical integration," AHA wrote. "It is notable that all of the federal agencies that administer these laws needed to provide guidance or waivers to make the Medicare Accountable Care Organization program feasible. However, their coordination ends outside of that narrow program." While mergers and acquisitions by health care providers "are vigorously policed by two federal and numerous state antitrust authorities," building a new continuum of care will require greater scrutiny of health plans, AHA said. "The growth in health insurance premiums from 2010 to 2011 was more than double that of underlying health costs, including the cost of hospital services," the statement notes.