We need to talk about why Sidibe v. Sutter, the federal antitrust case whose trial started this week, is important, worth your attention & bigger than @SutterHealth. 1/10
It was filed by businesses who bought health insurance for employees. They're suing the $13B health system arguing it has used monopoly power to drive up their costs--both care for members & premiums/copays--by at least $411M over the yrs. Background: bit.ly/3HJT4Rr 2/10
The suit says Sutter does this a few ways. One is by forcing health insurers to include ALL its #hospitals in their networks if they want ANY of them. So even if you just want Crescent City & East Bay, you've got include SF, Modesto, etc. 3/10
Sound familiar? This case is almost identical the highly-publicized California antitrust case Sutter settled in 2019 for $575M, UFCW & Employers Benefit Trust. bit.ly/3GHucsc (That's the one @SecBecerra intervened in.) But there's an important difference. 4/10
UFCW was filed by self-insured plans, companies that pay their own claims. Sidibe was filed by businesses that buy insurance from plans like @Aetna, @AnthemBCBS_News. It concerns employees that end up paying more for health insurance. 5/10
Plaintiffs not only must prove Sutter drove prices up, but that health plans passed higher costs onto members, which could be tricky. If they succeed, businesses nationwide could file similar suits against health systems accusing them of exploiting monopoly power. 6/10
In other words, there would be federal precedent, something the California case didn't provide. 7/10
USC's Glenn Melnick told me just about every health system is either actively forcing health plans into these "all-or-nothing" contracts or trying to build monopoly power. "This model has been copied across the country." 8/10
You know, I'm a little surprised we're even having a trial. Sutter settled the UFCW case the day opening arguments were scheduled. Trials are expensive & no one wants their dirty laundry aired in court. 9/10
Anyway, here's what attorneys on both sides said during yesterday's opening arguments in San Francisco: bit.ly/34wZcOt Follow @modrnhealthcr for updates! 10/10
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