lmplications of Health Care Competition for Cost, Choice, Quality, and Innovation: The Role of Antitrust Policy Prepared
The US. health care environment is changing rapidly. As employers and public agencies have tried to control spending, more health care is provided through managed care organizations. This approach to delivering care has reduced hospital use and led to thousands of empty beds. It also has spurred provider collaboration, for example through hospital mergers, physician networks, and physician-hospital delivery systems. Competitive pressures have also encouraged health insurers and HMOs to merge into large national or regional plans. An important issue facing health policy makers who are relying on competition to reduce health care spending is how this consolidation affects consumers. Does it reduce costs through increased efficiency and improve services through coordination? Or does it create organizations with market dominance that lead to higher prices and lower quality? This report examines the implications for health care cost, quality, innovation, and choice of the trends toward health care market consolidation.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
