Antitrust Measures Support Quality Patient Care

CHICAGO — Contrary to common perception, “the nation's antitrust laws allow—even encourage—doctors to collaborate in ways that lower costs and improve patient care,” according to Jon Leibowitz, chairman of the Federal Trade Commission.

If doctors join forces to fix prices, the FTC will stop them, but if they work together to deliver affordable, high-quality care, “not only will we leave you alone, we'll applaud you. And we'll do everything we can to help you put together a plan that avoids antitrust pitfalls,” Mr. Leibowitz said in a speech that sought to dispel any stereotype that physicians might have of the commission as being run by “fastidious bureaucrats” and “surreptitious socialists,” determined to keep doctors from charging fair prices for their services.

“Too often, I believe, our antitrust enforcement actions are portrayed as a barrier to improved care. If there is any stereotype I would like to disabuse you of today, that's the one,” he said.

The relationship between organized medicine and the FTC has become strained recently by physician opposition to the “Red Flags Rule” that requires small businesses, including medical practices, to develop policies to detect and prevent identity theft.

The American Medical Association, American Osteopathic Association, and Medical Society of the District of Columbia filed suit against the FTC in May to block it from enforcing the rule against physicians. The “bureaucratic burden” imposed by the rule “outweighs any benefit to the public,” Dr. Cecil B. Wilson, then AMA president-elect, said in a statement.

Mr. Leibowitz said the commission agrees with physicians that the rule is overreaching, and has urged Congress to provide a legislative fix for the issue as soon as possible. “Fastidious bureaucrats aren't pushing Congress to work quickly to fix the Red Flags Rule that has unintentionally swept up countless small businesses. … The FTC is,” he said.

Mr. Leibowitz cited several areas for potential cooperation between physicians and the FTC, all stemming from the Affordable Care Act. The use of health information technology to improve work flow and monitor populations and individuals; clinical integration; and accountable care organizations (ACO) are among the areas that hold potential for collaboration to improve quality and lower health care costs, he said.

Although they are not “a free pass to fix prices,” he said that health information technology systems “can be an important tool” to make patient care more effective and affordable. The FTC recently issued three favorable advisory opinions on HIT use by health care providers.

In the area of clinical integration, the FTC provides guidance to providers in the form of advisory opinions regarding joint ventures. The FTC will analyze a proposal and, where feasible, provide an opinion on whether it would recommend an enforcement action if the proposal were implemented, he said.

With regard to ACOs (integrated health systems that will be responsible for providing care to defined populations), “there is already talk of their moving into the private sector,” and “we want to work with you moving forward” to avoid competition issues, he said. “As long as the government purchases the services and unilaterally sets payment levels and terms, there won't be an antitrust issue.” He said the FTC will hold a public workshop this fall on competition policy, payment reform, and new care models, including ACOs.

CHICAGO — Contrary to common perception, “the nation's antitrust laws allow—even encourage—doctors to collaborate in ways that lower costs and improve patient care,” according to Jon Leibowitz, chairman of the Federal Trade Commission.

If doctors join forces to fix prices, the FTC will stop them, but if they work together to deliver affordable, high-quality care, “not only will we leave you alone, we'll applaud you. And we'll do everything we can to help you put together a plan that avoids antitrust pitfalls,” Mr. Leibowitz said in a speech that sought to dispel any stereotype that physicians might have of the commission as being run by “fastidious bureaucrats” and “surreptitious socialists,” determined to keep doctors from charging fair prices for their services.

“Too often, I believe, our antitrust enforcement actions are portrayed as a barrier to improved care. If there is any stereotype I would like to disabuse you of today, that's the one,” he said.

The relationship between organized medicine and the FTC has become strained recently by physician opposition to the “Red Flags Rule” that requires small businesses, including medical practices, to develop policies to detect and prevent identity theft.

The American Medical Association, American Osteopathic Association, and Medical Society of the District of Columbia filed suit against the FTC in May to block it from enforcing the rule against physicians. The “bureaucratic burden” imposed by the rule “outweighs any benefit to the public,” Dr. Cecil B. Wilson, then AMA president-elect, said in a statement.

Mr. Leibowitz said the commission agrees with physicians that the rule is overreaching, and has urged Congress to provide a legislative fix for the issue as soon as possible. “Fastidious bureaucrats aren't pushing Congress to work quickly to fix the Red Flags Rule that has unintentionally swept up countless small businesses. … The FTC is,” he said.

Mr. Leibowitz cited several areas for potential cooperation between physicians and the FTC, all stemming from the Affordable Care Act. The use of health information technology to improve work flow and monitor populations and individuals; clinical integration; and accountable care organizations (ACO) are among the areas that hold potential for collaboration to improve quality and lower health care costs, he said.

Although they are not “a free pass to fix prices,” he said that health information technology systems “can be an important tool” to make patient care more effective and affordable. The FTC recently issued three favorable advisory opinions on HIT use by health care providers.

In the area of clinical integration, the FTC provides guidance to providers in the form of advisory opinions regarding joint ventures. The FTC will analyze a proposal and, where feasible, provide an opinion on whether it would recommend an enforcement action if the proposal were implemented, he said.

With regard to ACOs (integrated health systems that will be responsible for providing care to defined populations), “there is already talk of their moving into the private sector,” and “we want to work with you moving forward” to avoid competition issues, he said. “As long as the government purchases the services and unilaterally sets payment levels and terms, there won't be an antitrust issue.” He said the FTC will hold a public workshop this fall on competition policy, payment reform, and new care models, including ACOs.

CHICAGO — Contrary to common perception, “the nation's antitrust laws allow—even encourage—doctors to collaborate in ways that lower costs and improve patient care,” according to Jon Leibowitz, chairman of the Federal Trade Commission.

If doctors join forces to fix prices, the FTC will stop them, but if they work together to deliver affordable, high-quality care, “not only will we leave you alone, we'll applaud you. And we'll do everything we can to help you put together a plan that avoids antitrust pitfalls,” Mr. Leibowitz said in a speech that sought to dispel any stereotype that physicians might have of the commission as being run by “fastidious bureaucrats” and “surreptitious socialists,” determined to keep doctors from charging fair prices for their services.

“Too often, I believe, our antitrust enforcement actions are portrayed as a barrier to improved care. If there is any stereotype I would like to disabuse you of today, that's the one,” he said.

The relationship between organized medicine and the FTC has become strained recently by physician opposition to the “Red Flags Rule” that requires small businesses, including medical practices, to develop policies to detect and prevent identity theft.

The American Medical Association, American Osteopathic Association, and Medical Society of the District of Columbia filed suit against the FTC in May to block it from enforcing the rule against physicians. The “bureaucratic burden” imposed by the rule “outweighs any benefit to the public,” Dr. Cecil B. Wilson, then AMA president-elect, said in a statement.

Mr. Leibowitz said the commission agrees with physicians that the rule is overreaching, and has urged Congress to provide a legislative fix for the issue as soon as possible. “Fastidious bureaucrats aren't pushing Congress to work quickly to fix the Red Flags Rule that has unintentionally swept up countless small businesses. … The FTC is,” he said.

Mr. Leibowitz cited several areas for potential cooperation between physicians and the FTC, all stemming from the Affordable Care Act. The use of health information technology to improve work flow and monitor populations and individuals; clinical integration; and accountable care organizations (ACO) are among the areas that hold potential for collaboration to improve quality and lower health care costs, he said.

Although they are not “a free pass to fix prices,” he said that health information technology systems “can be an important tool” to make patient care more effective and affordable. The FTC recently issued three favorable advisory opinions on HIT use by health care providers.

In the area of clinical integration, the FTC provides guidance to providers in the form of advisory opinions regarding joint ventures. The FTC will analyze a proposal and, where feasible, provide an opinion on whether it would recommend an enforcement action if the proposal were implemented, he said.

With regard to ACOs (integrated health systems that will be responsible for providing care to defined populations), “there is already talk of their moving into the private sector,” and “we want to work with you moving forward” to avoid competition issues, he said. “As long as the government purchases the services and unilaterally sets payment levels and terms, there won't be an antitrust issue.” He said the FTC will hold a public workshop this fall on competition policy, payment reform, and new care models, including ACOs.