Hospital

FTC Staff Opposes SUNY Hospital Merger Antitrust Exception

The Federal Trade Commission (FTC) urged New York’s Department of Health not to shield the State University of New York Upstate Medical University’s proposed acquisition of a private nonprofit hospital from antitrust scrutiny.

Crouse Health and SUNY Upstate Medical University announced the proposed deal in April. They applied for a state-issued authorization exempting hospital mergers from antitrust scrutiny known as a Certificate of Public Advantage, or COPA, in July.

“Research has shown that Certificates of Public Advantage frequently lead to higher prices and lower quality care for patients and lower wage growth for nurses, pharmacy workers, and certain other non-medical skilled workers,” said Elizabeth Wilkins, Director of the FTC Office of Policy Planning. “We do not believe granting this COPA will benefit the people of the state of New York.”

SUNY Upstate Medical University and Crouse Health System announced the proposed merger in April 2022, then filed a COPA application in July. The New York State Department of Health has invited public comments on the application.

In Onondaga County, N.Y., where the effects of the proposed merger would likely be felt most acutely by area patients and hospital workers, the merged entity would have a combined share of nearly 67 percent of commercially insured inpatient hospital services. Moreover, the proposed merger between SUNY Upstate and Crouse would reduce the number of hospital options available for nearly all patients in Onondaga County from three to two.

According to the comment, an analysis by the FTC staff indicates that SUNY Upstate currently competes closely with Crouse, which benefits patients and also results in optimal wages and benefits for hospital employees. The comment goes on to state that there is insufficient evidence to conclude that any benefits of the merger would outweigh the potential harms, and it is doubtful that regulatory conditions imposed by the state under the COPA would offset the potential anticompetitive harm to patients.

The FTC staff also expressed concern about a lack of transparency surrounding the COPA process, noting that the application has not yet been made readily available to the public. FTC staff submitted a public version and non-public version of its comment, with claimed confidential material redacted from the public version.

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