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On June 18, 2019, the Federal Trade Commission will hold a public workshop in Washington, DC to assess the impact of certificates of public advantage (“COPAs”) on prices, quality, access, and innovation for healthcare services. This workshop is part of a broader COPA Assessment Project announced in November 2017, when staff issued a request for empirical research and public comment.

State governments are increasingly using COPAs, which are regulatory regimes intended to displace competition among healthcare providers. COPAs may preclude antitrust scrutiny of mergers and collaborations, including hospital mergers, that otherwise would be likely to raise antitrust concerns. States have enacted COPAs with the assumption that regulatory oversight can mitigate the effects of lost competition and may allow hospitals to achieve certain efficiencies. The Commission is interested in empirical research on the actual benefits and harms associated with COPAs, and on qualitative analyses of stakeholders’ experience with COPAs. Such studies and analyses, as well as the information presented at this workshop, may help advance the agency’s policy and enforcement strategies.

At the June workshop, academics, health policy experts, healthcare industry stakeholders, state regulators and law enforcement officials, and staff from the FTC’s Bureau of Economics will discuss research regarding the effects of COPAs, as well as a study of price and quality effects following Phoebe Putney’s acquisition of Palmyra Memorial Hospital (which involved an otherwise anticompetitive hospital merger that was consummated due to state regulations). Participants will also discuss their practical experiences with COPAs.

Topics for discussion include:

  • What conclusions, if any, can be drawn from existing research on the effects of COPAs? What additional research is necessary or advisable to evaluate the effectiveness of COPAs?
  • What resources and expertise are required to implement and monitor the effectiveness of COPAs? What is the long-term viability of COPAs and likelihood that states will oversee COPAs in perpetuity?
  • Is competition more or less effective than regulation in generating optimal levels of price, quality, access, and innovation for healthcare services?

Interested parties may submit public comments electronically or in paper form on these topics or other related topics through July 31, 2019. For further information on the workshop and the public comment process, including instructions for filing comments in paper form and a list of additional suggested questions for comment, please visit the workshop website. If an entity has provided funding for research, analysis, or commentary that is included in a submitted public comment, please identify such funding and its source on the first page of the comment.

The workshop is free and open to the public. Seating will be on a first come, first served basis. Attendees may register in advance for the workshop by completing this registration form. The workshop starts at 9:00 a.m. at the FTC’s Constitution Center Auditorium, 400 7th St., SW, Washington, DC, and will be webcast live. Registration information, directions to the event, and information about reasonable accommodations are available on the workshop website. A detailed agenda and list of speakers will be available in the near future. For general questions about the workshop, please contact us at

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Contact Information

Betsy Lordan
Office of Public Affairs

Stephanie Wilkinson
Office of Policy Planning