Idaho publishers seek access to health care price information in antitrust case

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

reliefNews publishers in Idaho have asked the Ninth U.S. Circuit Court of Appeals in San Francisco to unseal pricing information that health insurers pay to hospitals and other providers in Idaho in an antitrust case stemming from a hospital system’s purchase of a physician group.

The publishers of the Idaho Statesman in Boise, the Idaho-Press Tribune in Nampa, and the Times-News in Twin Falls were joined by The Associated Press and the Idaho Press Club in the request to unseal the pricing data along with witness testimony and exhibits in the case, according to reports by Joe Carlson in Modern Healthcare and by Audrey Dutton in the Idaho Statesman.

The request was filed in November after U.S. District Court Judge B. Lynn Winmill failed to require lawyers to make compelling arguments for keeping the evidence sealed and keeping the courtroom closed at certain stages of the trial, Dutton reported.

Court documents (PDF) show that the pricing data was sealed before the trial began in September in Boise.

Reporting on the case in Modern Healthcare, Carlson wrote that the media companies argue that if Idaho’s employers had access to the pricing and other information from the trial, then the premiums consumers pay for health insurance might fall.

In March, the Federal Trade Commission and the Idaho Attorney General sought to unwind the acquisition by St. Luke’s Health System of Boise of Saltzer Medical Group, a 44-member physician group in Nampa. Before the health system completed the acquisition on Dec. 31, 2012, Saltzer was the largest independent, multispecialty physician practice group in the state. A not-for-profit health system, St. Luke’s owns and operates seven hospitals, the FTC said.

In an email, Dutton explained that the FTC and the attorney general’s office joined a lawsuit filed by two of St. Luke’s competitors: Saint Alphonsus Health System and a small surgical hospital in Boise. The competitors sued in November 2012 alleging antitrust violations, she wrote, adding that because the hospital plaintiffs, the FTC, and the attorney general were making the same arguments about antitrust, their cases were consolidated into one.

In announcing its intention to unwind the acquisition, the FTC said acquiring the Saltzer group would give St. Luke’s the market power to demand higher rates for health care services provided by primary care physicians. The result would be higher costs for health care consumers, employers and their employees, the FTC said.

“St. Luke’s acquisition of Saltzer Medical Group has created a dominant single provider of adult primary care physician services in Nampa, with a nearly 60 percent share of the market,” said Richard Feinstein, director of the FTC’s Bureau of Competition.

When the FTC’s antitrust case ended last fall, Winmill said he intended to issue a ruling in November, Dutton said in her email. “My impression from his clerk is that a decision is still a ways out,” she added.

Dutton reported in October that participants in the antitrust trial asked Winmill to shield hundreds of case documents from public view to protect trade secrets. The documents reveal details about the acquisition, compensation that St. Luke’s and its main rival proposed for independent doctors and other particulars about the Saltzer purchase, Dutton wrote.

Molly Gamble reported in Becker’s Hospital Review that the news organizations claimed more than half of the first seven days of testimony occurred behind closed doors and more than 575 exhibits were sealed.

The case could define how antitrust regulators view hospital acquisitions of doctor practices for years to come, according to Modern Healthcare. Although the FTC seeks to identify anti-competitive deals involving hospitals and doctors, the trial in Boise marked was the first time the agency has litigated such a deal in a courtroom, the newsmagazine said.

Editor’s note: AHCJ thanks Audrey Dutton (@IDS_Audrey) for her contributions to this report. 

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