Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Mergers & Acquisitions
August 01, 2022 11:39 AM

What's at stake in the UnitedHealth-Change Healthcare antitrust trial

Nona Tepper
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    UnitedHealth_Group_AP_fullsize_i_i_i copy_i.png
    AP

    The Justice Department lawsuit seeking to block UnitedHealth Group's $13 billion acquisition of data broker Change Healthcare in federal court began Monday.

    The government sued to block the deal in February, alleging it would violate federal antitrust restrictions by giving UnitedHealthcare access to proprietary information on how rival health insurers structure their provider networks.

    UnitedHealth Group has argued that adding Change Healthcare's claims clearinghouse technology to its Optum healthcare services subsidiary would lower costs for health insurance companies and providers and, in turn, for patients. The companies initially planned to close the deal last year, and now aim to complete the transaction by Dec. 31.

    The trial began in the U.S. District Court for the District of Columbia on Monday and is slated to last two weeks. Judge Carl Nichols, a former clerk for Supreme Court Justice Clarence Thomas whom President Donald Trump nominated to the court in 2019, is presiding.

    What UnitedHealth Group wants

    UnitedHealth aims to add Change Healthcare's claims processing service to its OptumInsight revenue cycle management operation. OptumInsight, the Optum subsidiary's smallest division, was responsible for $3.2 billion of Optum's $45 billion in revenue during the second-quarter.

    Acquiring Change Healthcare would enable OptumInsight to scale its payment processing, claims review and administrative services, according to UnitedHealth.

    Optum plans to integrate Change Healthcare's claims data and automated payment processing tool to accelerate payments to providers and to more transparently bill insurers and patients, the company said in a news release announcing the deal in January 2021.

    UnitedHealth would leverage Change Healthcare's clinical data to offer providers analytical decision support for individual patients. That would advance Optum's value-based care initiatives, the company said.

    Optum would utilize Change Healthcare's patient engagement tool—which reaches more than 200 million people a year—with members' insurance policies to promote health incentive programs. The acquisition builds on UnitedHealth's plan to make Optum patients' entry point into the parent company's brand.

    In June, Optum reportedly paid an undisclosed sum to buy Irving-based Healthcare Associates of Texas from private equity firm Webster Equity Partners. Also this year, UnitedHealth announced plans to buy Lafayette, Louisiana-based home health and hospice provider LHC Group, behavioral health and substance abuse chain Refresh Mental Health of Jacksonville Beach, Florida, and the Kelsey-Seybold Clinic medical group in Houston.

    In addition to being the largest U.S. health insurer by membership with 51.2 million policyholders, UnitedHealth is the largest employer of physicians, with more than 60,000 doctors working at Optum.

    Why the government is suing

    If the deal is completed, UnitedHealth would hold a monopoly on the claims clearinghouse market, the Justice Department alleges. That would give it insight into what rivals pay providers and how they structure their networks, according to the lawsuit.

    Nine of the nation's 10 largest insurers rely on Change Healthcare to review, revise and reimburse claims, the Justice Department lawsuit says. These companies contract with Change Healthcare to avoid conducting business with a competitor, OptumInsight, according to the government.

    The acquisition would give UnitedHealth control of more than 75% of the claims editing market and leave other insurers with little choice but to work with a competitor, according to the Justice Department. Because Change Healthcare is the leading electronic data interchange clearinghouse among providers, insurers would be unable to bypass UnitedHealth even if they switched service providers, as their insurance data would still pass through Change Healthcare's network, the Justice Department lawsuit says.

    Hospital, pharmacy and antitrust advocates have echoed the Justice Department's argument. They oppose the deal over monopoly concerns and maintain the acquisition would raise costs. The American Hospital Association and National Community Pharmacists Association support Justice Department's move to block the acquisition.

    UnitedHealth's plan for approval

    If the acquisition advances, UnitedHealth would sell Change Healthcare's claims editing business for $2.2 billion to private equity firm TPG Capital. If the transaction is not completed, Change Healthcare would retain ClaimsXten.

    UnitedHealth would also pay a $650 million fee to Change Healthcare if the transaction is not completed because of a court decision.

    The company also agreed to purchase another $60 million of Change Healthcare's services when the deal was announced in January 2021, the Justice Department wrote in the lawsuit. That means that even if the deal falls through, Change Healthcare would have gained a valuable customer, the government alleges.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    handshake deal
    GHR Healthcare acquires Barton Healthcare Staffing
    Northwell-Health-and-Nuvance
    Northwell Health acquires Nuvance Health
    Most Popular
    1
    Here are new state healthcare laws taking effect in 2025
    2
    Meet Modern Healthcare's 2025 Leading Women
    3
    New York-Presbyterian layoffs affect 2% of employees
    4
    Evernorth, Optum, CenterWell units buoyed insurers in Q1
    5
    Epic CEO Judy Faulkner on AI, antitrust and consolidation
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content