Thread by @Farzad_MD

1/ "Federal antitrust oversight has proved inadequate at preventing anticompetitive effects across the health care sector" per @commonwealthfnd

What else can the federal government do, given the difficulty of passing healthcare legislation?

Plenty.
commonwealthfund.org/blog/2021/fede…

2/ in this article, Joseph Kannarkat and I break down all the tools that the Biden administration and @SecBecerra have to address competition beyond antitrust reviews

jamanetwork.com/journals/jama-…

3/ first of all, if the Biden administration chooses to elevate health care competition as a priority, it may garner rare bipartisan support.

This is an issue that has support from left (@ZekeEmanuel) and right (@Avik) thought leaders and legislators.

4/ removing perverse incentives to consolidate in payment policies can arrest or reverse hospital-physician consolidation.

The appeals court upheld @CMSGov ability to enact site-neutral payments.

they need to be expanded beyond office visits to other services, like ultrasounds

5/ fight against state-level anticompetitive ploys

"Certificate of Need" is often abused to grant local monopolies that then drive up prices

CMS has set the precedent of saying "if there's a CON, we will provide additional flexibilities on network adequacy"- they can go further

6/ Enforce against holding data hostage.

I joined 5 other former national coordinators for Health IT in an unprecedented letter that supported using CMS Conditions of Participation as a tool for ensuring data sharing of hospital events.

We have a final rule, but no enforcement

7/ the FTC and DOJ should review physician non-competes.

They shouldn't be used to stifle competition if physicians find that hospital (or private equity) employment was not all they hoped it would be

8/ @JoeBiden was the first presidential candidate of a major party to explicitly call out the need to tackle market concentration in healthcare

But they can go beyond antitrust authority to ensure better care and lower costs for all.