- Associated Press - Wednesday, January 29, 2014

BOISE, Idaho (AP) - Recently released documents in an antitrust lawsuit against a Boise medical center show the company’s planned merger could have raised some health care costs as much as 60 percent.

A federal judge last week found that St. Luke’s Regional Medical Center violated antitrust laws when it purchased the Nampa-based Saltzer Medical Group. The ruling and order to nullify the year-old merger came after St. Luke’s competitor, St. Alphonsus Regional Medical Center, and the Federal Trade Commission sued, contending the merger would erode competition for primary medical care services and result in higher prices for patients.

The Idaho Statesman (https://bit.ly/1jJtgqd) reports that on Tuesday, U.S. District Judge B. Lynn Winmill unsealed documents that influenced his decision. Among the documents was an analysis by a consultant for St. Luke’s who found office and outpatient visits could be billed at amounts about 60 percent higher if the visits were St. Luke’s-based rather than Saltzer-based. Other documents suggest that insurance billing rates could increase around 30 percent.

Lawyers for St. Luke’s and insurance company Blue Cross of Idaho asked the judge not to reveal some facts in the documents, arguing that they contained trade secrets. But Winmill denied the requests.

“The facts and figures sought to be redacted are crucial to the court’s analysis, and their removal would render the decision indecipherable,” Winmill said.

Much of the four-week trial happened behind closed doors, and many documents were sealed or heavily redacted. Lawyers for the hospitals - and for insurance companies and local employers - marked those parts of the trial private because they said they needed to protect trade secrets.

Several news organizations in Idaho, including The Associated Press and Idaho Statesman, challenged the secrecy in an effort to pry open the court proceedings and documents. That case is now before the 9th U.S. Circuit Court of Appeals.

Winmill said in his decision Tuesday to make his ruling public that when the trial started, he thought there were compelling reasons to keep parts of it veiled. But as it went on, those reasons seemed less compelling, he said.

Some of the statements that St. Luke’s sought to keep out of the public records, released by Winmill on Tuesday:

- “By 2012, St. Luke’s had three of the top five highest-paid hospitals, and its top hospital was receiving reimbursements 21 percent higher than the average Idaho hospital.”

- “After the acquisition, if St. Luke’s were to bill for (routine services such as lab tests or X-rays) at the higher ‘hospital-based’ rates, (Blue Cross of Idaho) estimates that costs … would increase by 30 to 35 percent.”

- “Consultant Peter LaFleur prepared an analysis at the direction of St. Luke’s showing how office/outpatient visits could be billed for higher amounts if the visit was hospital-based rather than Saltzer-based. The hospital-based billings were more than 60 percent higher.”

Blue Cross of Idaho also sought to keep some facts away from competitors and the public, including a paragraph explaining how the company pays more than the average U.S. insurer:

“Across the United States, the average commercial insurance plan pays about 120 percent of what Medicare pays. For overnight hospital stays in Idaho, (Blue Cross) pays between 150 percent to 200 percent more than Medicare pays. For outpatient hospital services, (Blue Cross) pays 300 percent more than Medicare. For routine office visits, (Blue Cross) pays 140 percent more than other commercial plans,” the document said.

Winmill said in his ruling that Idaho insurance rates for a routine doctor’s office visit are higher than 95 percent of those paid by other insurance plans nationwide.


Information from: Idaho Statesman, https://www.idahostatesman.com



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