1. What factors changed the state’s healthcare market according to the case?

2. How did St. Luke justify its market dominance?

3. What complaints did the doctors have about both hospitals St. Luke and St. Alphonsus Health Care System?

4. What complaints did St. Alphonsus Healthcare System have against St. Luke?

5. Why would cost or changes increase if services are performed within a hospital setting versus an independent physician’s office?

6. What are the advantages of directing physician referrals within one system of care? Disadvantages?

7. As you know, one problem with our US Healthcare System is the coordination of care among providers. Therefore, the Affordable Care Act encouraged vertical integration (look this up in your book)  and consolidation to improve the coordination of care. However, as you see in this case, too much consolidation can give one organization too much market power. What can be done to balance the need to coordinate care and maintain some level of competition?

The Battle In Boise Case/Article From New York Time