Hospital mergers to change via new FTC, DoJ guidelines
The Federal Trade Commission (FTC) and Department of Justice (DoJ) have issued revised Horizontal Merger Guidelines that outline how the federal antitrust agencies evaluate the likely competitive impact of mergers and whether those mergers comply with U.S. antitrust law, which will affect future acquisitions and mergers among hospitals.

The Horizontal Merger Guidelines, which were first adopted in 1968, and revised in 1992, serve as an outline of the main analytical techniques, practices and enforcement policies the FTC and the DoJ use to evaluate mergers and acquisitions involving actual or potential competitors under federal antitrust laws.

Many of the proposed refinements and changes reflect issues previously identified in the "Commentary on the Horizontal Merger Guidelines," which the agencies jointly issued in 2006. In crafting the revisions, the agencies said they considered a range of opinions gathered through a series of joint public workshops, as well as hundreds of public comments submitted by attorneys, academics, economists, consumer groups and businesses.

These 2010 guidelines are different from the 1992 guidelines in several ways, including that they:
  • Clarify that merger analysis does not use a single methodology, but is a fact-specific process through which the agencies use a variety of tools to analyze the evidence to determine whether a merger may substantially lessen competition.
  • Introduce of a new section on "Evidence of Adverse Competitive Effects,” which discusses several categories and sources of evidence that the agencies, in their experience, have found informative in predicting the likely competitive effects of mergers.
  • Explain that market definition is not an end itself or a necessary starting point of merger analysis, and market concentration is a tool that is useful to the extent it illuminates the merger's likely competitive effects.
  • Provide an updated explanation of the hypothetical monopolist test used to define relevant antitrust markets and how the agencies implement that test in practice.
  • Update the concentration thresholds that determine whether a transaction warrants further scrutiny by the agencies.
  • Provide an expanded discussion of how the agencies evaluate unilateral competitive effects, including effects on innovation.
  • Provide an updated section on coordinated effects. The guidelines clarify that coordinated effects, like unilateral effects, include conduct not otherwise condemned by the antitrust laws.
  • Provide a simplified discussion of how the agencies evaluate whether entry into the relevant market is so easy that a merger is not likely to enhance market power.
  • Add new sections on powerful buyers, mergers between competing buyers, and partial acquisitions.

"A primary goal of the 2010 guidelines is to help the agencies identify and challenge competitively harmful mergers while avoiding unnecessary interference with mergers that either are competitively beneficial or likely will have no competitive impact on the marketplace," the agencies said in a joint statement. "To accomplish this, the guidelines detail the techniques and main types of evidence the agencies typically use to predict whether horizontal mergers may substantially lessen competition."

These changes mark the first major revision of the merger guidelines in 18 years.