Busey R C
Gardner Carton & Douglas, Chicago, IL., USA.
Healthc Financ Manage. 1997 May;51(5):86-7.
After careful consideration of possible anticompetitive harm and payer reaction, the Department of Justice has chosen not to challenge as unlawful a provider-controlled, nonexclusive physician network in Santa Fe, New Mexico, even though the network will include 70 percent of the area's pediatricians. Reasons for the DOJ's decision include evidence of substantial risk sharing by the physician members, an arrangement by the network to provide a different compensation system for non-member participating physicians, and the pediatricians' promise that they will participate in the network on a nonexclusive basis. In addition, the member pediatricians will be a small minority of the primary care physicians whose compensation will be paid out of one fixed revenue pool. The DOJ's decision thus signals support for a provider network model for smaller communities.
在仔细考虑了可能的反竞争危害和付款方的反应后，美国司法部决定不对新墨西哥州圣达菲市一个由医疗服务提供者控制的非独家医生网络提出非法质疑，尽管该网络将涵盖该地区70%的儿科医生。美国司法部做出这一决定的原因包括：医生成员有大量风险分担的证据、该网络为非成员参与医生提供不同薪酬体系的安排，以及儿科医生承诺将以非独家方式参与该网络。此外，成员儿科医生将只是少数，而这些初级保健医生的薪酬将从一个固定收入池中支出。因此，美国司法部的这一决定表明其支持为较小社区建立的医疗服务提供者网络模式。
