A multibillion-dollar acquisition involving an insurance coverage big and well being expertise business has the nation’s most outstanding hospital group very involved.
The American Hospital Association sent a letter to the Department of Justice Wednesday, saying that Minnetonka, Minnesota-based UnitedHealth Group’s plans to buy Change Healthcare via its subsidiary Optum is anticompetitive.
Optum plans to buy Change Healthcare in a $13.5 billion all-cash transaction, including the well being expertise business’s software program, knowledge analytics capabilities, analysis and income cycle administration choices to its roster. The deal, introduced in January, is predicted to shut within the second half of the yr.
The hospital affiliation — which incorporates practically 5,000 members — is urging the Justice Department’s Antitrust Division to conduct an intensive assessment of the transaction, saying it could scale back competitors within the sale of well being IT services and products to suppliers.
Specifically, the acquisition may decrease competitors within the following areas, the group mentioned within the letter:
- Claims clearinghouse providers
- Payment accuracy providers
- Revenue cycle administration providers
- Clinical resolution help providers
Change Healthcare, primarily based in Nashville, Tennessee, serves as a “key independent competitor that is similar in size to Optum in these essential services,” which suggests the acquisition will lead to increased costs for suppliers and decrease high quality of look after sufferers, the letter states.
While Optum didn’t instantly touch upon the letter, it seems to carry the alternative view.
The acquisition “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,” wrote an Optum spokesperson, who declined to be named, in an electronic mail.
The assertion added that “Optum and Change Healthcare share a vision for better health outcomes and experiences for everyone, at lower cost.”
Change Healthcare didn’t reply to a request for remark.
Reducing competitors within the sale of services and products isn’t the American Hospital Association’s solely concern.
The acquisition would consolidate “competitively sensitive” healthcare knowledge and shift it from Change Healthcare, a third-party, to Optum, a subsidiary of UnitedHealth Group, the hospital group mentioned.
“Change’s independence from payers and its function as an ‘honest broker’ is another critical element of competition,” the affiliation argued.
UnitedHealth Group’s possession of UnitedHealthcare — the largest health insurer within the nation by membership — adds to Change’s lack of independence.
Combining Change and Optum’s knowledge units “would impact (and likely distort) decisions about patient care and claims processing and denials to the detriment of consumers and healthcare providers, and further increase UHG’s already massive market power,” the letter states.
Optum has mentioned that it’ll maintain an “informational firewall” between OptumInsight and UnitedHealth Group, however it has not demonstrated that the firewall is strong and can stop info sharing, the group mentioned.
This is the second time this yr that the American Hospital Association has accused UnitedHealth of partaking in anticompetitive conduct.
In February, the hospital group sent letters to the Centers for Medicare & Medicaid Services and the Federal Trade Commission, asking the companies to assessment two UnitedHealthcare insurance policies that they claimed may block market competitors and entry to care.
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