New factors in the antitrust regulation of hospital mergers.

This research considers four recent hospital merger attempts in smaller urban areas where a hospital merger clearly presents antitrust concerns, as determined by the Federal Trade Commission (FTC) or Department of Justice (DOJ). These cases provide an understanding of the more compelling strategies that hospitals are using to offset federal antitrust concerns and the increased number of factors that are being used by the FTC and DOJ to analyze a merger's effect on a market. In particular, the cases illustrate how federal agencies' likelihood of contesting a merger is now based on the merging hospitals' ability to provide strong evidence of substantial savings resulting from a merger. Further, evidence indicates that states are taking on increasing authority for the oversight of hospital mergers. This federalism trend suggests that consumer protection for hospital mergers may be enhanced through a combination of federal and state oversight measures.