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WASHINGTON — The Biden administration this month quietly rescinded pivotal, Obama-era guidelines that let physicians sidestep antitrust scrutiny if they were pursuing certain kinds of “value-based” care — yet another sign that it’s taking a closer look at consolidation among doctors and hospitals.

When Democrats passed the Affordable Care Act more than a decade ago, they hoped that getting doctors and hospitals to take on a role akin to insurers would encourage them to lower health care costs by averting expensive hospitalizations and avoiding redundant or excess services. Some physicians formed so-called accountable care organizations, which are networks of doctors, hospitals, and other health care facilities given a fixed budget to care for a large group of patients. If an ACO comes under budget, without skimping on care, Medicare shares back some of the savings.

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