Opinion ID: 2778249
Heading Depth: 4
Heading Rank: 2

Heading: PCP Reimbursements

Text: The district court also found that St. Luke’s would likely use its post-merger power to negotiate higher reimbursement rates from insurers for PCP services. Recognizing that the § 7 inquiry is based on a prediction of future actions, see Phila. Nat’l Bank, 374 U.S. at 362, this finding was not clearly erroneous. ST. ALPHONSUS MED. CTR. V. ST. LUKE’S HEALTH SYS. 19 Because St. Luke’s and Saltzer had been each other’s closest substitutes in Nampa, the district court found the acquisition limited the ability of insurers to negotiate with the merged entity. Pre-acquisition internal correspondence indicated that the merged companies would use this increased bargaining power to raise prices. An email between St. Luke’s executives discussed “pressur[ing] payors for new directed agreements,” and an exchange between Saltzer executives stated that “[i]f our negotiations w/ Luke’s go to fruition,” then “the clout of the entire network” could be used to negotiate favorable terms with insurers. The court also examined a previous acquisition by St. Luke’s in Twin Falls, Idaho, and found that St. Luke’s used its leverage in that instance to force insurers to “concede to their pricing proposal.”