Section 7.06 - Factors Considered in a Cost and Market Impact ReviewA Cost and Market Impact Review may examine factors relating to the Provider or Provider Organization's business and its relative market position, including, but not limited to:
(1) The Provider or Provider Organization's size and market share within its Primary Service Areas by major service category, and within its Dispersed Service Areas;(2) The Provider or Provider Organization's prices for services, including its relative price compared to other Providers for the same services in the same market;(3) The Provider or Provider Organization's health status adjusted total medical expense, including its health status adjusted total medical expense compared to similar Providers;(4) The quality of the services it provides, including patient experience;(5) Provider cost and cost trends in comparison to total health care expenditures statewide;(6) The availability and accessibility of services similar to those provided, or proposed to be provided, through the Provider or Provider Organization within its Primary Service Areas and Dispersed Service Areas;(7) The Provider or Provider Organization's impact on competing options for the delivery of Health Care Services within its Primary Service Areas and Dispersed Service Areas including, if applicable, the impact on existing service Providers of a Provider or Provider Organization's expansion, affiliation, Merger or Acquisition, to enter a Primary or Dispersed Service Area in which it did not previously operate;(8) The methods used by the Provider or Provider Organization to attract patient volume and to recruit or acquire health care professionals or facilities;(9) The role of the Provider or Provider Organization in serving at-risk, underserved and government payer patient populations, including those with behavioral, substance use disorder and mental health conditions, within its Primary Service Areas and Dispersed Service Areas;(10) The role of the Provider or Provider Organization in providing low margin or negative margin services within its Primary Service Areas and Dispersed Service Areas;(11) Consumer concerns, including but not limited to, complaints or other allegations that the Provider or Provider Organization has engaged in any unfair method of competition or any unfair or deceptive act or practice; and(12) Any other factors that the Commission determines to be in the public interest.Adopted by Mass Register Issue 1277, eff. 1/2/2015.