Applying conventional horizontal merger enforcement rules to mergers of nonprofit hospitals is controversial. Critics contend that the different objective function of not-for-profits entities should mitigate, and possibly eliminate, competitive concerns about mergers involving nonprofit hospitals. We provide evidence relevant to this debate by analyzing ex post a horizontal merger in a concentrated hospital market. Here, the transaction reduced the number of competitors (both nonprofit) in the alleged relevant market from three to two. We find that the transaction resulted in significant price increases; we reject the hypothesis that these price increases reflect higher post-merger quality. This study should help policymakers assess the validity of current merger enforcement rules, especially as they apply to not-for-profit enterprises.

The health care industry continues to undergo unprecedented consolidation. Health care providers and payors alike have pursued a wide variety of integrative strategies to achieve efficiencies or other business advantages. The Health Care Mergers and Acquisitions Handbook is designed to educate the practitioner about the antitrust analysis of mergers and acquisitions within the health care industry. Over the past two decades there has been an extraordinary amount of litigation related to challenges of hospital mergers. Each chapter identifies and analyzes important antitrust issues governing such consolidations. Accordingly, the first several chapters are devoted to a detailed treatment of substantive issues peculiar to such mergers: an introduction to hospital merger litigation, describing trends in litigation and the way in which such mergers are analyzed; issues unique to market definition, including product market definition and geographic market definition; the competitive effects of hospital mergers, assessing the evidence necessary to establish a prima facie case in a merger challenge and the rebuttal arguments offered by merging parties; a unique rebuttal argument offered by merging hospitals that is treated separately due to its prominent role in hospital merger litigation - the role and significance of efficiencies in determining the competitive merits of such mergers; the potential applicability of the state action doctrine to hospital mergers. In addition to a substantive treatment of hospital mergers, the Handbook also addresses; combinations of health care management organizations (HMOs) and physician practice groups; the analysis used by the enforcement agencies when reviewing mergers of HMOs; antitrust issues posed by physician practice consolidations. The appendix contains a chart summarizing litigated hospital mergers.--

Predicting Successful Hospital Mergers and Acquisitions examines the rapidly changing acute care hospital of the health care delivery industry. It provides a set of guidelines for human service industry executives considering a merger or acquisition to keep organizations competitive and efficient in the current managed care environment. This model is applicable to various health care providers such as skilled nursing facilities, psychiatric care hospitals, and rehabilitation facilities.