Last fall, the Federal Trade Commission (FTC) won appellate reversals in two hospital merger cases: Penn State Hershey and Advocate Health, which is now on remand in the district court. Along with its successful 2015 challenge to a merger of physician groups, the FTC has built formidable legal support in three US Courts of Appeals for its antitrust approach to health care mergers.

Health systems must now ask: Are competitor collaborations a viable strategy for achieving efficient scale, lower costs, better quality and more value from insurer contracts that reward quality?