United States v. Long Island Jewish Medical Center

In response to a merger agreement between Long Island Jewish Medical Center and North Shore Health Systems, Inc. (collectively, the institutions) (defendants), the United States government (plaintiff) filed an antitrust action in federal district court under the Clayton Act to prevent the merger. The government claimed that the merger constituted anticompetitive behavior. The district court held a hearing, during which evidence was presented on the consumers affected and the relevant product and geographic markets. The government’s expert claimed that the consumers affected by the merger were managed-care organizations. The institutions’ expert claimed that the consumers were not only the managed-care organizations but also the consumers of health services within Queens, Nassau, and Suffolk, which were the primary areas the institutions served. The government’s expert also testified that the relevant product market was acute inpatient services provided by anchor hospitals, which are hospitals carrying prestigious reputations. The institutions’ expert claimed that the relevant product market was general acute-care inpatient hospitals. The government’s expert testified that the relevant geographic market was Nassau and Queens because those were the two areas surrounding the institutions. The institutions’ expert testified that the relevant geographic market was Nassau, Queens, western Suffolk, and Manhattan. However, the evidence presented indicated that patients receiving primary- and secondary-care services stayed within Queens and Nassau but patients receiving tertiary-care services were willing to travel to Manhattan and western Suffolk.