Correspondence issued by the Government Accountability Office with an abstract that begins "Stakeholdershealth care industry groups and experts in antitrust lawhad different perspectives on the adequacy of three key aspects of antitrust guidance for health care provider collaboration. First, stakeholders perspectives differed on the sufficiency of guidance on clinical integration, which involves integrating clinical activities across providers in a collaborative arrangement. Clinical integration is one way for a collaborative arrangement to satisfy the requirement that the arrangement demonstrate the potential to yield significant benefits, such as reduced costs or improved quality, in order to be able to jointly negotiate prices. Five of the six experts and one of the four industry groups said that agency guidance was sufficient, while one expert and two industry groups asserted that agency guidance on clinical integration was inadequate. Second, stakeholders perspectives differed as to whether the agencies should permit greater use of exclusive collaborative arrangements, which restrict the ability of providers within a collaborative arrangement to contract with other arrangements or health plans. The use of exclusive arrangements has the potential to improve or reduce competition, depending on the circumstances. Four of the experts said that the agencies guidance on exclusive arrangements was reasonable, while three industry groups stated that the agencies should permit greater use of exclusive arrangements. Third, stakeholders perspectives differed on the adequacy of guidance related to which collaborative arrangements are exempt from the antitrust analysis and therefore are presumed to be lawfulknown as being within a safety zone. One of the four industry groups and one of the six experts said the size and scope of the safety zones outlined in the 1996 Statements were appropriate, while three industry groups and three experts contended that the safety zones should be expanded to include a wider range of arrangements.