HCA Healthcare targeted in latest antitrust lawsuit
The health care system is accused of exercising "restraint of trade and unlawful monopolization" leading to exorbitant prices in North Carolina.
Has our country reached a tipping point in its tolerance for rampant consolidation and monopolistic behavior in the health care industry? Following last week’s news about the Department of Justice’s interest in UnitedHealth’s acquisition of Change Healthcare, we’re also seeing greater pushback at a regional level. In North Carolina, HCA Healthcare, the country’s largest for-profit health care operator, is facing a class-action lawsuit. Among a long list of grievances, the suit alleges that HCA-owned MIssion Health used its monopoly power to increase prices, insurance rates and deductibles throughout its services area.
“An out-of-state corporation has used its market power to cut quality and raise prices,” said attorney Mona Lisa Wallace. “Mission Health was once the crown jewel of North Carolina’s healthcare system. In filing this action, the Plaintiffs seek to have HCA live up to its promises of providing affordable health care in Western North Carolina.”
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Consumer grievances go back to 1995, well before the 2019 acquisition of Mission by HCA. For more than 25 years, the hospital system has exercised “restraint of trade and unlawful monopolization,” according to the lawsuit. Currently, HCA holds an estimated 90% of the market share for inpatient acute care in two counties, as well as a more than 70% market share in seven other counties in the region.
“Consolidation of hospital systems is one of the biggest drivers of rising health care costs,” attorney Jamie Crooks of Fairmark Partners said in the statement. “The complaint alleges that, through a variety of anti-competitive practices, HCA has overcharged for health care.”
The plaintiffs are seeking refunds for overages charged, as well as a change in the health care system’s practices and pricing. According to data cited in the complaint, “HCA currently charges more than two times the State average for a C-section without complications.” The higher prices charged by HCA and Mission have resulted in more expensive insurance premiums, the lawsuit alleges–as much as 50% to 60%.
The complaint also addresses declines in quality of care over the past two years, as well as cuts to staffing and non-compliance with price transparency regulations.
The lawsuit has caught the eye of legislators in the state.
“I do think there is a gap, a regulatory gap, and what the fix is for that, we can start having those conversations,” State Sen. Julie Mayfield said. “This lawsuit is not the be-all, end-all, fix-all of the problem, but we do hope it is a strong step in the right direction in addressing many issues and concerns we have heard.”
One major fix would be to give the state’s attorney general more oversight of transactions in the health care space, including greater regulation of quality and price parameters.
“I would like to see that this becomes a launching point for addressing a lot of the broad issues that we’ve seen,” Mayfield said.
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