Justice Department targets health system consolidation 'detrimental to our economy'

President Joseph Biden attacked anticompetitive acquisitions earlier this year with an executive order to crack down on them, and the U.S. Justice Department plans to follow suit.

Associate Attorney General Vanita Gupta spoke at the 15th annual Global Antitrust Enforcement Symposium at Georgetown Law School Sept. 14, emphasizing the department's focus on preventing monopolies and maintaining a competitive economy.

"This work is urgently needed," she said. "In many industries, consolidation is greater now than it was even just 20 years ago. For example, today, dominant health systems can approach 50 percent control of a relevant local or regional market. This kind of consolidation can be detrimental to our economy."

Ms. Gupta cited the department's efforts to block a merger between Aon and Willis Towers Watson as an example of actions to come. The merger would have left the insurance broker industry with just two dominant players.

"The department's success in stopping the merger of Aon and Willis Towers Watson was an important victory," she said. "It is also an important warning sign to companies contemplating similar deals. I know antitrust division officials have said this before, but I hope companies are, in this moment, paying close attention: Anticompetitive mergers should not make it out of the boardroom. If they do, we will not hesitate to challenge those mergers."

The focus on keeping markets competitive could be a boon for independent surgery centers.

"Concentrating the power in the hands of a few entities has proven to be bad for healthcare," Adam Bruggeman, MD, a spine surgeon with Texas Spine Care in San Antonio, told Becker's. "ASCs are a dynamic space that have multiple potential purchasers and operators. I don't think there will be a reduction in quality for ASCs, and the continued scrutiny will benefit ASC growth."

As an early test of the executive order, Marion (Ill.) HealthCare, a multispecialty ASC, filed a lawsuit July 29 to challenge a Carbondale-based Southern Illinois Hospital Service's planned acquisition of Harrisburg (Ill.) Medical Center. Marion argued in its suit that the merger would give Southern Illinois Hospital Service a monopoly in the market, raise healthcare costs and make it more challenging for the center to recruit physicians.

Some ASC leaders anticipate the increased scrutiny on healthcare mergers will spark a flurry of acquisitions in the coming months to get ahead of the curve.

"Hospital systems acquiring ambulatory centers will become more prominent, as they will want to have control over the number of competitive entities that threaten their elective surgical volume," said Tracy Helmer, administrator of Seven Hills ASC in Henderson, Nev. "The ASC will always remain the cost-conscious, and in some cases, significantly safer alternative than the hospital setting. The only option that hospital systems have is to scoop up the competition, if possible."


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