How Come There Aren't More Hospital Antitrust Cases? With Brennan Bilberry—Summer Shorts 1

Why Hospital Antitrust Cases Are So Rare, With Brennan Bilberry (Summer Shorts 1)

3 Reasons Antitrust Lawsuits Against Consolidated Hospital Systems Are So Uncommon. Summer Shorts 1.

If hospital consolidation is as anticompetitive as critics say, why aren't more health systems getting sued over it? In this summer short, Stacey Richter talks with Brennan Bilberry, founding partner of Fairmark Partners, a law firm litigating antitrust cases against dominant hospital systems, about three structural reasons private antitrust litigation against hospitals remains rare — revisiting his original conversation on the topic, EP395.

WHAT YOU'LL LEARN

✅ Why a continuing lack of price and contract transparency makes it hard to even know whether a hospital system's conduct is illegal, let alone prove it in court

✅ How the political power of hospitals as major local donors makes legislatures reluctant to pass laws that would make antitrust litigation easier to bring

✅ Why the FTC is "a little toothless" when it comes to tax-exempt, nonprofit hospital systems — even when their market conduct resembles what a for-profit monopolist would be punished for

✅ What certificates of public advantage are and how they can shield anticompetitive hospital mergers from ordinary antitrust scrutiny

✅ Why private antitrust litigation is an important recourse when transparency gaps and regulatory limits leave hospital systems largely unchecked

WHY THIS MATTERS

Hospital consolidation has reshaped local health care markets for years, but the legal tools meant to check anticompetitive behavior — transparency requirements, FTC enforcement, state legislation — all have real gaps that dominant systems can exploit. Brennan Bilberry's work at Fairmark Partners shows why private litigation has become one of the few levers left when regulators are outmatched by hospitals' political and financial power.

MENTIONED IN THIS EPISODE

EP395 with Brennan Bilberry: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

✉️ Enjoy this podcast? Subscribe to the free weekly newsletter

🫙 Support the podcast with a small donation to the Tip Jar

🎤 Listen on Apple Podcasts

🎤 Listen on Spotify

📺 Subscribe to our YouTube channel

=== CONNECT WITH THE RHV TEAM ===

✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X

00:00 Introduction

00:23 Healthy Economist's review of Relentless Health Value.

00:52 Why aren't more people suing hospitals?

01:16 How is the lack of transparency diminishing the number of lawsuits?

01:41 Why is the FTC "a little toothless" when it comes to nonprofits?

02:35 Why aren't there as many antitrust cases as there are instances of antitrust laws being broken?

03:10 Has consolidation of hospital systems been good or bad?

03:45 What quirk in the law creates an impediment for the FTC?

04:17 What are certificates of public advantage?

05:03 Why is private antitrust litigation important?