Public healthcare interests require strict competition enforcement

Loozen, Edith

doi:10.1016/j.healthpol.2015.02.005

Cited by 14 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In market-based healthcare systems, where providers are expected to compete, scrutiny and enforcement of competition rules are an important part of safeguarding the public healthcare interest. 45,46 In the Netherlands, collaboration agreements and mergers between companies-including healthcare organisations-are assessed under the Competition Act (Mededingingswet), which came to effect in 1998. It can be regarded as the Dutch equivalent of the Treaty on the Functioning of the European Union [TFEU] 1957.…”

Section: Legal Framework and Competition Enforcementmentioning

confidence: 99%

Reasons for merging and collaborating in healthcare: Marriage or living apart together?

van der Schors,

Roos,

Kemp

et al. 2023

Health Planning & Management

View full text Add to dashboard Cite

BackgroundAcross OECD countries, integration between healthcare organisations has become an indispensable part of contemporary healthcare provision. In recent years, inter‐organisational collaboration has increasingly been encouraged in health and competition policy at the expense of mergers. Yet, understanding of whether healthcare organisations make an active choice between merging and collaborating is lacking. Hence, this study systematically examines (i) healthcare executives' motives for integration, (ii) their potential trade‐offs between collaborating or merging, and (iii) the barriers to collaborating perceived by them.MethodsEarly 2019, an online questionnaire was conducted among a nationwide panel of 714 healthcare executives in the Netherlands. Because of their strategic position within healthcare organisations as end‐responsible managers, healthcare executives are especially suited to provide broad and in‐depth knowledge on the internal and external processes and decisions. Three hundred thirty‐seven Dutch healthcare executives completed the questionnaire (response rate 47%). This study sample was representative of the largest healthcare sectors in the Netherlands. In total, 137 mergers and 235 inter‐organisational collaborations were reported. Both closed questions and open‐ended questions were systematically analysed.ResultsImproving or broadening healthcare provision is the foremost motive for mergers as well as inter‐organisational collaborations. When considering both types, reducing governance complexity is one of the decisive reasons to opt for a merger, whereas aversion towards a full merger and lack of support base within the own organisation convinced healthcare executives to choose for a collaboration. When comparing specific healthcare sectors, the overlap in pursued motives and sub‐motives indicates that inter‐organisational collaborations and mergers are used for comparable objectives. Only a small minority of the responding executives switched between both types of integration. Institutional barriers, such as laws, regulations and financing regimes, appear to be the most restricting for healthcare executives to engage in inter‐organisational collaborations.ConclusionsOur integral approach and systematic comparison across sectors could serve policymakers, regulators and healthcare providers in aligning organisational objectives and societal objectives in decision‐making on collaborations and mergers. Future research is recommended to study multiple collaboration and merger cases qualitatively for a detailed examination of decision‐making by healthcare executives, and develop an integral assessment framework for balancing collaborations and mergers based on their effects in the medium to long term.

show abstract

Section: Legal Framework and Competition Enforcementmentioning

confidence: 99%

Reasons for merging and collaborating in healthcare: Marriage or living apart together?

van der Schors,

Roos,

Kemp

et al. 2023

Health Planning & Management

View full text Add to dashboard Cite

show abstract

“…In the Netherlands, collaboration agreements between companies are assessed under the Competition Act (Mededingingswet), which came into effect in 1998 and is based on EU competition law. Collaboration-the form of coordination that we focus on in this paper-can be impermissible under the Competition Act if the objective of that collaboration is anti-competitive, or if it leads to anti-competitive effects (Loozen, 2015). The Authority for Consumers & Markets (ACM) is responsible for applying the Competition Act in all competitive markets, including the market for healthcare.…”

Section: Antitrust Enforcement For Collaboration Agreementsmentioning

confidence: 99%

Collaboration and Competition Policy in a Market-Based Hospital System: A Case Study from the Netherlands

Schors¹,

Kemp²,

Varkevisser³

2020

Journal of Competition Law &Amp; Economics

View full text Add to dashboard Cite

In the Dutch healthcare system, provider competition is used as a tool to improve efficiency. From a competition policy perspective, little is known about how collaboration among healthcare providers contributes to overall patient welfare, and how a balance is achieved between scale benefits and preventing anti-competitive collusion. This paper examines the ex-post effects of a Dutch case study in which three competing hospitals have collaborated to provide high-complexity low-volume cancer surgery, an arrangement that tests the limits of permissibility under the Dutch cartel prohibition. Our preliminary empirical research demonstrated only a modest increase in price and travel time for some of the tumour surgeries. Volume analysis showed that the intended centralization of surgical procedures has not been fully realized. Our findings highlight the importance of a comprehensive self-assessment by the collaborating hospitals to ex-ante assess (potential) efficiencies and antitrust risks. Such self-assessments could benefit from research focused on which collaborations are most appropriate to achieve quality gains. For the ex-post assessment by competition authorities following the cartel prohibition, a more thorough insight into the (long-term) changes in hospital prices, profitability, and quality after collaboration is needed.

show abstract

“…While their work underlines the mechanism that pro-competitive reforms influence the healthcare market, it also highlights the reverse interplay between the meso and macro level. In related work, Gaynor and Vogt [93] and Loozen [94] have for example discussed the rationale behind, issues with, and required adaptations of anti-trust enforcement in health care.…”

Section: The Macro Meso Micro Interplaymentioning

confidence: 99%

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

et al. 2017

View full text Add to dashboard Cite

Public healthcare interests require strict competition enforcement

Cited by 14 publications

References 12 publications

Reasons for merging and collaborating in healthcare: Marriage or living apart together?

Reasons for merging and collaborating in healthcare: Marriage or living apart together?

Collaboration and Competition Policy in a Market-Based Hospital System: A Case Study from the Netherlands

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

Contact Info

Product

Resources

About