Certificates of public advantage (COPAs) grant antitrust immunity to merging hospitals conditional on active state regulation. We investigate the long-run effects of the four horizontal hospital mergers shielded with COPAs prior to 2015. We find that COPA regulation, if properly designed, can...

We examine 558 hospital mergers during a period of increased antitrust enforcement. Using US data on commercially insured patients from 2009-2016, we estimate an average price effect of roughly 5% with a smaller effect for mergers later in the sample. Mergers between hospitals that were...

Certificates of Public Advantage (COPAs) grant antitrust immunity to merging hospitals conditional on active state regulation. We investigate the effects of three mergers shielded with COPAs: Benefis in Great Falls, Montana, Palmetto in Columbia, South Carolina, and MaineHealth’s acquisition...