ACA, antitrust law aren't in conflict, FTC director says

Sharply disagreeing with critics, a recently appointed Federal Trade Commission official says the goals of the Affordable Care Act don't conflict with traditional antitrust law.

Martin Gaynor, a healthcare economist who joined the FTC in October as director of its Bureau of Economics, entered the long-running national conversation about antitrust and reform in a letter to the New York Times on Monday:

"The Federal Trade Commission is committed to protecting American consumers from any anticompetitive arrangements among providers. But we do not stand in the way of providers' finding new ways of coordinating and improving care. The FTC has challenged only a handful of the hundreds of mergers, acquisitions and new arrangements in the healthcare industry over the last few years. Moreover, there are many ways for providers to effectively coordinate care that do not require merger or acquisition or cause competitive concerns."

The letter came in response to a Feb. 4 New York Times article about a federal judge's decision to side with the FTC and order Idaho's largest provider, Boise-based St. Luke's Health System, to unwind its 2012 acquisition of the state's biggest physician practice, Saltzer Medical Group, based in Nampa. The decision takes place amid a broader pattern of provider consolidation in response to many factors, including reform, experts say.

Reacting to the ruling, St. Luke's officials said the FTC's decision to sue to block the merger conflicted with the reform law's goals to encourage broader coordination of care in the market. The CEOs of three other health systems told Modern Healthcare the same thing for a cover story in December 2012:

"The FTC is operating from law that was passed over many years to address a set of issues, and healthcare reform is working with a different set of laws ... and the two have not had the time or energy to collaborate about how the two sets of laws need to be symbiotic," said Jim Miller, who at the time was CEO of Renown Health in Reno, Nev.

Next up with major news in this area will likely be ProMedica.

The Toledo, Ohio-based system is expecting a decision that could come any day from the 6th U.S. Circuit Court of Appeals in Cincinnati. ProMedica was ordered to divest a northern Ohio hospital after an FTC challenge in 2011. Oral arguments before a three-judge panel happened in March 2013, with friend-of-the-court briefs filed by the American Hospital Association and America's Health Insurance Plans.

Experts say that case is likely to be appealed to the Supreme Court.

Follow Joe Carlson on Twitter: @MHJCarlson