“Per Se” Illegal Under The FTCs’ Analysis
Explain Why An Arrangement Would Be Found “Per Se” Illegal
Under The FTCs’ Analysis.
A physician-hospital organization (PHO) consists of 15 hospitals –
with 2,247 staffed beds – and approximately 500 physicians. The
PHO operates in a very large section of south Georgia, including
the cities of Valdosta, Tifton, Thomasville, Moultrie, and Waycross.
The PHOs’ physician members represent approximately 90
percent of all physicians practicing in the region.
The PHO served as a vehicle through which competing hospitals
and physicians could bargain collectively with health plans to
obtain higher fees for themselves. The owner PHOs, member
hospitals, and member physicians canceled contracts with payors
and informed them that the PHO would be the sole entity through
which they would enter into payor contracts. To contract with the
PHO, payors allegedly have had to accept the fixed physician fee
schedule and fixed discount of no more than 10 percent off
hospital list prices.
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