The Robert Wood Johnson Foundation (RWJF) published a George Washington University’s School of Public Health and Human Services brief examining the antitrust implications of proposed legislation in the House and Senate to create Accountable Care Organizations (ACOs) to serve Medicare and Medicaid patients.  The antitrust concerns stem from the legislation’s proposal that ACOs act as a single delivery organization in which physicians and hospitals merge operations.  The brief found that the legislation is consistent with longstanding antitrust policies.

From the report:

This analysis examines accountable care organizations (ACOs) and assesses their implications for antitrust policy. Consideration of the antitrust implications of ACOs is timely. Both the House and Senate health reform measures contemplate the creation of ACOs as a new class of Medicare provider while providing parallel legal authority under Medicaid. It is also possible that using existing law, the Obama administration might launch ACOs on a pilot demonstration basis. We begin with a brief overview of the ACO concept and describe legislative proposals to establish ACOs as a formal Medicare and Medicaid provider class subject to special payment rules. We then examine antitrust policy as it relates to clinical and financial integration in health care and consider how antitrust principles might facilitate the formation and operation of ACOs.

Full report:  Accountable Care Organizations: Implications for Antitrust Policy (PDF | 226.81 KB)

Robert Wood Johnson Foundation. (2010). Accountable care organizations: Implications for antitrust policy. Burke, T. and Rosenbaum, S.