Health First settles with physicians on anti-competitive allegations for keeping referrals within the health system: 5 things to know

Central Florida’s Health First, a health system with four hospitals and a multispecialty group, decided to settle allegations of anti-competitive actions with a collection of independent physicians, according to a Medscape report.

Here are five things to know:

1. The physicians alleged Health First committed antitrust violations, claiming the health system pressured the physicians to refer patients exclusively to the hospitals, physician specialists and ancillary services within the health system; those that didn’t were dropped from Health First’s insurance provider panels.

2. The physician practices that didn’t comply with Health First’s request report lost revenues and lost patients.

3. Health First had previously acquired the largest independent physician group in the area — the plaintiffs — and ordered physicians to admit patients within the system. The plaintiffs argued the monopoly on physician services drove up costs and hurt competition.

4. Health First countered the lawsuit, saying the plaintiffs lacked evidence to support their claims and defended its policy as integrated care delivery. They maintained the physicians were “disgruntled” by downward pressure on reimbursements and the evolution of healthcare networks.

5. The trial ended on the second day with a settlement although it is unclear whether the health system will pay any money to the physicians, reinstate the physicians dropped from the health plan or divest itself of the practice.

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