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St. Luke’s, the Supreme Court, and Saltzer

By Dr. David C. Pate, News and Community
July 16, 2015

The question for St. Luke’s as to whether to appeal our antitrust case to the U.S. Supreme Court has been an important one, and one we have not taken lightly.

From the beginning, St. Luke’s has known that it was doing the right thing for the right reason in aligning with physicians who share our vision to expand services for everyone, regardless of ability to pay, and to work together to ensure that providers are rewarded for providing value to those we have the privilege of serving. The highly committed physicians and staff members of Saltzer Medical Group felt the same way, so strongly that they approached St. Luke’s with their request to integrate with our organization.

Our mutual aim, acknowledged by U.S. District Court Judge B. Lynn Winmill in his ruling following trial, has always been to improve the quality of care and services offered to our communities.

It was our shared vision to decrease the fragmentation of the healthcare delivery system by sharing a single electronic health record to make care seamless for patients and their families, to increase the coordination of care by bringing new specialists to Canyon County and offering our care management programs to the Saltzer physicians and their patients, to increase the quality of care by incorporating evidence-based medicine, and to improve the health of the people of Canyon County.

The District Court found that St. Luke’s and Saltzer’s plans and efforts were likely to improve quality, but Judge Winmill noted that the law did not allow the court to consider these benefits and thus, he had no choice other than to find that the transaction was not permitted under current antitrust law.

In considering an appeal to the Supreme Court, we considered opinions from other courts, the fact that the decision is counter to well-established law in antitrust cases decided under a similar law for transactions that have already been completed, and the fact that the Supreme Court has never before addressed this question of law.

After dozens of deliberate and considered discussions with Saltzer colleagues, we have decided against an appeal. Among the reasons: the distraction this litigation has been at a time when our efforts need to be devoted to improving the health of the people of the communities we serve, improving the care for patients, and lowering the cost of that care; the statistically low chance that the Supreme Court would agree to hear our case; and the litigation fatigue that all stakeholders have suffered.

This has been a very difficult question, at every step involving our valued Saltzer Medical Group colleagues and our community volunteer board members.

St. Luke’s has received an incredible outpouring of support and encouragement from across our communities and around the country. We heard from patients, physicians, company, hospital, and health system leaders, academicians, attorneys, and others, all of whom understood that law outgrows its usefulness and can be well-served by a meaningful, intentional challenge. On the other hand, sometimes it has to be enough to know you were right and to accept that healthcare may be evolving faster than the law can keep up.

We do believe that the judicial system has been very thoughtful about our case. We are glad that we had an opportunity to be heard and to present our case.

I am firmly convinced that the state attorney general and his staff and the FTC attorneys always believed that they had the best interests of those they serve at heart, and they have been thoroughly professional and courteous during the course of this case. As an attorney, I can appreciate the amount of work and effort all parties have put into making sure the promise of jurisprudence was met.

Having decided to proceed with the divestiture of the Saltzer Medical Group regardless of the decision to appeal, and considering the considerable amount of time it would take until this matter could be finally adjudicated, we will move forward without appealing.

This now concludes the matter. We will continue to work with our Saltzer colleagues to advance the goals and the vision that we share for the greater good of our communities; that focus, which caused Saltzer to seek the integration, has not changed in the slightest.

The Saltzer physicians and staff have inspired me throughout this process. They have always had the most to lose, but they care so deeply about their patients and believed so passionately that they could be a part of fixing what is wrong with healthcare that they were willing to put it all on the line.

High principles and ideals are easy to have when there is no cost. I admire those that stick to these principles and ideals when there is much at risk.

To see the announcement, click here.

About The Author

David C. Pate, M.D., J.D., previously served as president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009 and retired in 2020. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.