Kootenai Health not trying to monopolize industry

COEUR d'ALENE - Kootenai Health isn't trying to corner the market on health care in the region.

"We're not out to monopolize any sector of the health care industry," said Ron Lahner, a Kootenai Health vice president and the hospital and health center's general counsel.

Lahner told The Press Tuesday afternoon that Kootenai Health feels competition in the marketplace is a good thing.

Earlier in the day, the 9th Circuit Court of Appeals upheld a federal court ruling that the Boise-based St. Luke's Health System violated federal antitrust laws when it acquired Saltzer Medical Group, a large, independent physicians' practice in the Nampa area.

Lahner noted U.S. District Court Judge B. Lynn Winmill said the court was convinced the quality of health care would improve if the merger remained in place, but the acquisition had to be unwound because of the antitrust laws.

The Sherman Antitrust Act, passed by Congress in 1890, was the first U.S. law to outlaw monopolization in business. The Clayton Act and the Federal Trade Commission Act were each enacted in 1914.

"Those rules still apply, whether you're making cars, widgets or delivering health care," Lahner said.

Under the federal Affordable Care Act, also known as "Obamacare," one of the principle themes is integration of care, he said. Hospitals have been encouraged to partner with other providers in an effort to improve patient outcomes while driving down costs through consolidation.

"So you start to do that, and lo and behold, you run up against these anti-trust rules," Lahner said.

He said the administration at Kootenai Health is not vigorously pursuing medical practices for acquisition.

"We have physicians coming to us requesting we acquire their practices and offer employment," Lahner said.

Kootenai Health scrutinizes each opportunity, he said, and considers acquisition only if hospital leaders believe the move will improve health care.

Lahner said it's not a core strategy for the hospital and health center, although they do like having a balance of hospital-employed and independent physicians.

There are 379 physicians on staff, Lahner said, and 95 are employed rather than independent.

"We do have several core strategies, one of which is to develop what we're calling a 'clinically integrated network,'" Lahner said.

For that network, he said Kootenai Health is contacting types of health care providers in order to integrate functions and services from a quality standpoint.

"This gets into that tension of integration and antitrust laws," Lahner said. "So we are engaged in this delicate dance in finding what's needed to deliver higher quality care at a lower cost, and more effectively, while staying on the right side of the antitrust laws."