Cory Capps is a principal in the Health Care Practice, Bates White, in Washington, D.C.
David Dranove is a professor in the Kellogg School of Management, Northwestern University, in Chicago, Illinois.
Health Aff (Millwood). 2017 Sep 1;36(9):1556-1563. doi: 10.1377/hlthaff.2017.0054.
The growing concentration of physician markets throughout the United States has been raising antitrust concerns, yet the Department of Justice and the Federal Trade Commission have challenged only a small number of mergers and acquisitions in this field. Using proprietary claims data from states collectively containing more than 12 percent of the US population, we found that 22 percent of physician markets were highly concentrated in 2013, according to federal merger guidelines. Most of the increases in physician practice size and market concentration resulted from numerous small transactions, rather than a few large transactions. Among highly concentrated markets that had increases large enough to raise antitrust concerns, only 28 percent experienced any individual acquisition that would have been presumed to be anticompetitive under federal merger guidelines. Furthermore, most acquisitions were below the dollar thresholds that would have required the parties to report the transaction to antitrust authorities. Under present mechanisms, federal authorities have only limited ability to counteract consolidation in most US physician markets.
美国各地医生市场的日益集中引起了反垄断担忧，但美国司法部和联邦贸易委员会在这一领域仅挑战了少数几笔并购交易。利用来自人口超过全美 12%的各州的专有索赔数据，我们发现，根据联邦并购准则，2013 年有 22%的医生市场高度集中。医生执业规模和市场集中程度的大部分增加是由众多的小规模交易而非几笔大规模交易导致的。在那些增加幅度足以引起反垄断担忧的高度集中的市场中，只有 28%的市场发生了联邦并购准则下被认为具有反竞争性质的个别收购。此外，大多数收购都低于需要向反垄断当局报告交易的金额门槛。在目前的机制下，联邦当局只有有限的能力来对抗美国大多数医生市场的整合。
