That interpretation in turn limited the definition of the geographic market to include a single competitor within Orange County. Two groups, said the DOJ, were too few. The DOJ was not persuaded that the network was necessary to accomplish those efficiencies, e.g., quality protocols, centralized scheduling and group purchasing. Payers have also indicated that they prefer to work with a single, integrated practice group rather than 16 individual physicians. The two situations differ, of course, in that the Orange County case involved a partially integrated network, while the Maryland group would create a single, fully integrated new group out of 16 solo practices.
Networks are inherently more suspect to the antitrust enforcers.
Another major difference appears to be the manner of presentation to the DOJ investigators. Some antitrust lawyers believe that the Orange County groups could have had a favorable outcome if the facts and arguments had been marshaled otherwise. The handwriting appears to be on the wall. The future is brighter for well-organized anesthesiology groups than for solo practitioners. As do many other medical specialty organizations, ASA has serious concerns about the methodologies that HCFA is exploring.