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1 1 (November 2022)

handle is hein.amenin/aeiaely0001 and id is 1 raw text is: Key Points A Addressinq coi:nso:idation in the health care services market is an impe atve as health care services now represent over 51 percent of national health care expenditures, 90 percent of netropolitan statistical areas are considered consolidated for hspita servdesand 65 percent of metropolitan statistical areas are considered consolidated for outpatient scialty care. * Robust research has documented the harms of hospital consolidation, including higher prices for services, higher insurance premiums and consumer cost sharing, lack of quality gains, anci decrernents in the patient experience. Pciicymnakers Lhave multiple tools to improve antitrust enforcement, modifyv existirig pay- rment policies that drive consolidation, and promote entry in. the market for hospital care ani other health care services. With over $78 billion in the Coronavirus Aid, Relief, and Economic Securit (CARIES) Act fPnds distributed to health care providers over the past two years, recent concern has focused on how incumbent and often well-resourced health sys- tens deployed government funding. Exanmples are numerous, with the financially stable Cleveland Clinic receiving CARES Act funds while reporting record 2021 operating income during the pande.mi. With over $12 billion in long-term investments and easy access to debt financing even during the height of the pandemic, with a $65) million credit line and $447 million in investment Income, the Cleveland Clinic was well positioned to weather a niultivear financial storm. Despite pandemic tinan-- cial pressures, the organization turned a net profit due to receiving over $352 million in CARES Act funds The Cleveland Clinic purchased a finan- cially distressed hosptal from the Sisters of Mercy Health System in the clinic's home Ohio nmarket in December 2020 and opened a private hospital in London in 202. In this context, policymrakers have appropri- ately begun to question the market power of health care systems in consolidated markets. While many recent policy efforts have focused on prescription drug prices, health care services represent a signif- lcans portion of the nation's healtn care expendi- tures, with hospital care representing 30.8 percent cr $u trillion annually, while spending on phuysi- cian services has reached 19,6 percent of national expenditures or over $8oo cillin annually.6 Ninety percent of mnero olitan statistical areas (MSAs) represent highly concentrated hospital

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