The Federal Trade Commission finalized a settlement in May with private-equity firm Welsh, Carson, Anderson & Stowe, limiting its future role in anesthesiology deals after allegations it had spearheaded a roll-up strategy with its portfolio company, U.S. Anesthesia Partners. The FTC’s lawsuit against USAP itself, however, is still moving forward in federal court.
At the center of the case is Texas, where anesthesia costs jumped nearly 30% after USAP consolidated most large practices in Houston and Dallas
Here are five things to know:
After USAP acquired large anesthesia groups, commercial prices increased 18% within six months and nearly 30% within two years. The sudden jumps contrasted with stable trends before consolidation.
Once practices were acquired, they were moved onto USAP s higher commercial fee schedules. This administrative shift — not gradual inflation — was found to be responsible for most of the cost increase.
The FTC alleged USAP bought almost every large anesthesia practice in major Texas metros, leaving hospitals and insurers with few contracting alternatives.
“Along with a set of unlawful agreements to set prices and allocate markets, these tactics enabled USAP and Welsh Carson to raise prices for anesthesia services — raking in tens of millions of extra dollars for these executives at the expense of Texas patients and businesses,” then-FTC Chair Lina Khan said in a 2023 news release.
Beyond acquisitions, consolidation was paired with contracting practices that reduced competition — such as aligning rates across practices and limiting entry by rival groups. These strategies strengthened USAP’s leverage in negotiations with commercial payers, contributing to higher reimbursement levels.
Even after new anesthesia practices entered Texas markets, their presence had little effect on reversing USAP’s higher prices. This suggests that once consolidation pushed rates upward, competition did not restore costs to prior levels.
Editor’s note: Becker’s has reached out to USAP and will update the story if more information becomes available
