Healthcare
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NERA’s economic experts specialize in healthcare matters and have been recognized for their expertise at the intersection of healthcare and economics. Our experts routinely analyze a broad range of healthcare topics, including healthcare antitrust matters; contracting and reimbursement disputes; analyses of quality, effectiveness, and outcomes; healthcare policy and regulation, such as certificate of need and certificate of public advantage matters; and healthcare class action matters.
Mergers, Acquisitions, and Joint Ventures
NERA economists have extensive experience in all phases of merger and joint venture analysis, including pre-deal antitrust risk assessment; responding to federal and state investigations, including second requests from the US Department of Justice and Federal Trade Commission; analyzing and assisting with the negotiation of divestitures and post-transaction conduct settlements; conducting retrospective analysis of completed transactions; and providing expert analysis and testimony during the litigation of challenged transactions.
Notable cases include:
- University of Rochester acquisition of Finger Lakes Health
- Gentiva’s acquisition of ProMedica’s Home Health and Hospice Business
- LifePoint’s acquisition of Kindred Health
- Walgreens/VillageMD’s acquisition of Summit Health
- Beth Israel Lahey Health’s acquisition of Exeter Hospital
- United Healthcare’s (Optum) acquisition of Change Healthcare
- Cedars-Sinai/Huntington Hospital Affiliation
- CVS Health/Aetna Merger
- Jefferson Health/Albert Einstein Healthcare Network Acquisition
- United HealthCare Group’s Acquisition of DaVita Physician Practices
- Washington State AG Challenge to CHI Franciscan’s Acquisition of Two Physician Groups
- Merger of Five Eastern Massachusetts-Based Health Systems
Contracting and Reimbursement
NERA economists know the ins and outs of healthcare contracting and have substantial experience with issues involving alternative payment methodologies, quality- and risk-based reimbursement, bundling and discounting, exclusive relationships, and joint ventures.
Notable cases include NERA’s work on the Healthcare Accountable Care Organization Arbitration.
Healthcare Policy and Regulation
NERA economists work at the forefront of many policy and regulatory issues in healthcare, including projects concerning certificates of need (CON), certificates of public advantage (COPA), regulatory and legislative hearings, and policy studies.
Notable cases include:
- Indiana Hospital Association Market Concentration Study
- Patient Demand Study for Certificate of Need Application
- California Department of Insurance Review of Centene/Health Net Affiliation
Healthcare Antitrust Litigations
NERA economists regularly work on healthcare antitrust litigations involving issues including monopolization, foreclosure of horizontal and vertical rivals, tying and bundling, exclusive contracting, group boycotts, price fixing and conspiracies, and data and information sharing.
Notable cases include:
- US Department of Justice and State of North Carolina Suit Against Atrium Health
- Surescripts Antitrust Litigation
- Southern Illinois Healthcare against claims of exclusive dealing, tying and monopolization brought by Marion Healthcare
- Jefferson Health and Albert Einstein Healthcare in merger challenge brought by FTC
- Hackensack Meridian Health and Englewood Healthcare in merger litigation brought by FTC
- Advocate Healthcare and NorthShore Health in merger litigation brought by FTC
- BCBS Louisiana, BCBS Kansas and Humana against alleged conspiracy claims brought by United Allergy Services
Quality, Effectiveness, and Outcomes
NERA economists understand the complexity involved with analyses of quality, effectiveness, and outcomes in healthcare. Our work in this area includes undertaking economic analyses and building economic frameworks to assist merging parties better quantify the impact of proposed transactions on quality.
Notable cases include NERA’s work on behalf of Hackensack Meridian Health and Englewood to support the analyses undertaken by a Clinical Quality expert retained by the parties in their merger challenge brought by the FTC. NERA has also undertaken such analyses as part of merger reviews and helped parties present such analyses to the antitrust agencies.
Class Action
NERA economists understand the unique aspects of class action cases in healthcare and have worked on class certification and merits stages of numerous cases.