Comstock's magazine 0919 - September 2019 | Page 41

did for most of the surrounding counties, especially to the
east. Amador and Calaveras counties both show up as hot
spots, with the highest rating of 6. El Dorado County came
in at 5, making it among the 10 most concentrated markets
in the state.
WILL CHALLENGES CHANGE THE PICTURE?
Politicians are pushing back against the threat of consoli-
dation and rising prices. State legislators have introduced
at least two bills since 2016 designed to provide more over-
sight of health care mergers and forbid anticompetitive
practices, though neither passed.
And an important lawsuit is testing the power of gov-
ernment to regulate large providers’ negotiating practices.
In March 2018, the state attorney general filed an antitrust
lawsuit against Sutter, joining an earlier antitrust class
action complaint brought by employers and labor unions.
They allege the health system engages in anticompeti-
tive practices that have pushed up costs. Those allegedly
include all-or-nothing contracts that force insurers that
it contracts with to accept all of Sutter’s sites regardless
of considerations like location or price. They charge that
Sutter includes gag clauses through which it forbids in-
surers from sharing price information with customers or
California Rice
competitors. And its contract terms forbid insurers from
giving their patients financial incentives to use lower-cost,
non-Sutter providers, the plaintiffs say. The case was
scheduled to go to trial in September.
A Sutter spokesperson declined to respond to ques-
tions Comstock’s sent by email about the allegations.
Sutter spokesperson Amy Thoma Tan instead released a
statement that read, in part, “Sutter Health is vigorously
defending itself against what we believe are baseless alle-
gations brought by self-interested plaintiffs whose lawsuit
is supported by insurance companies. It is insurance com-
panies who will benefit from the remedies sought through
this litigation, not Northern California patients. ... The Af-
fordable Care Act explicitly encourages integrated models
of care like Sutter Health to foster better quality and value
in healthcare. … Yet the plaintiffs suing us want to dis-
mantle Sutter’s integrated network.”
That response gets at an important question experts
have debated, including at an October Health Affairs fo-
rum in Sacramento: Is it possible to have an integrated
health system, which most everyone agrees is a good idea,
without financial consolidation? The 2010 ACA did create
financial incentives for health care providers to integrate
by forming accountable care organizations, or ACOs —
Twice the Benefits
A shallow amount of water
in local rice fields provides
two distinct benefits –
growing food and providing
vital environmental benefits.
Farms in the Sacramento
Valley provide virtually all
of America’s sushi rice, as
well as habitat for millions
of birds.
Learn more at
CalRice.org/TwiceTheBenefits
September 2019 | comstocksmag.com
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