A federal antitrust case in which the appellate opinion suggests that providers can freely deal with (or even refuse to deal with) insurance companies even where the providers have a “natural monopoly” (the market is just too small to support additional providers). At trial it was argued that a provider (Marshfield Clinic and its wholly-owned HMO) had violated federal antitrust laws by signing up virtually all of the physicians within its market area into its managed care program with exclusive contracts, thereby preventing an insurance company (Blue Cross & Blue Shield of Wisconsin and its HMO) from competing on a “level playing field.” The jury in the original federal district court case agreed with Blue Cross and awarded them $48 million, after trial reduced to around $20 million. Virtually every issue at trial, however, was reversed in September 1995 by the Court of Appeals for the Seventh Circuit. Central to the appellate courts opinion was the conclusion that HMOs were not a separate or unique health care market in the area, but simply another way of pricing medical care, much like PPOs or other forms of managed care.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
A federal antitrust case in which the appellate opinion suggests that providers can freely deal with (or even refuse to deal with) insurance companies even where the providers have a “natural monopoly” (the market is just too small to support additional providers). At trial it was argued that a provider (Marshfield Clinic and its wholly-owned […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":["post-112615","post","type-post","status-publish","format-standard","hentry","category-m"],"yoast_head":"\n