The American Hospital Association on Wednesday asked the Department of Justice to investigate UnitedHealth Group's proposed acquisition of Change Healthcare, warning that the move could reduce competition in health IT services.
According to the letter, UnitedHealth Group and Change Healthcare sold off assets that drive hundreds of millions of dollars to ward off antitrust scrutiny from regulators. Hospitals also worried that UnitedHealth Group, which owns the largest insurance company in the nation, would consolidate much of the country's healthcare data and use it to process and deny claims.
"Post-merger, Optum will have strong financial incentives to use competitive payers' data to inform its reimbursement rates and set its competitive clinical strategy, which will reduce competition among payers and harm hospitals and other providers," the AHA wrote.
UnitedHealth Group's fastest-growing subsidiary, Optum, announced in January that it would pay approximately $8 billion to acquire Change Healthcare. Analysts predicted that acquisition would allow Optum to expand its OptumInsight provider business, inform its value-based care initiatives and increase patient engagement.
"The transaction will result in an anticompetitive loss of head-to-head competition between Optum and Change," the letter said.
But Optum and Change Healthcare claim that combining the two firms would improve health outcomes and lower costs.
"With distinct and complementary capabilities, this combination will help healthcare providers and payers better serve patients by more effectively connecting and simplifying key clinical, administrative and payment processes to the benefit of the health system and the people we serve," an Optum spokesperson said in an email.
Hospitals are especially concerned about a loss of competition in claims clearinghouse, payment accuracy, revenue cycle management and clinical decision support services.
OptumInsight and Change "are the two largest national providers of these services and scale is a key factor in choosing a health care IT provider," the AHA wrote. "Healthcare IT companies with data volume, variety and velocity are at a substantial and sustainable advantage over smaller, niche competitors."
Consolidation is growing among providers, insurers, vendors and other players in the healthcare sector. Research shows that a small handful of companies increasingly dominate their markets, a trend that's accelerated in recent years. Healthcare insiders, policymakers and the public are increasingly concerned those trends are increasing healthcare costs, lowering access to care and could potentially reduce innovation in the long-term.
Lawmakers and regulators have yet to take significant action to turn the tide, but that could begin to change under the Biden administration.
