The Department of Justice and the state of Ohio filed an antitrust lawsuit against OhioHealth this week, alleging the health system used “all-or-nothing” contracting practices to force payers into include every hospital and physician affiliated with OhioHealth in their networks.
Essentially, the lawsuit claims that the Ohio-based health system has used its market dominance to impose restrictive payer contracts that harm competition and drive up healthcare costs for patients and employers.
According to the lawsuit, OhioHealth requires payers to include all of its hospitals and employed physicians in their networks if they want access to any of them, which has prevented payers from selectively contracting with lower-cost facilities or excluding higher-priced ones.
The DOJ argues this has left payers with little negotiating leverage, as well as hurt their ability to design more affordable health plans.
“Americans deserve low-cost, high-quality healthcare — not anticompetitive hospital system contracts that make healthcare less affordable,” Attorney General Pam Bondi said in a statement.
The DOJ and Ohio contend that OhioHealth’s provisions violate federal and state antitrust laws by suppressing competition among hospitals and physician groups in central Ohio. By foreclosing rivals from competing for inclusion in payer networks, the complaint alleges that the inappropriate practices helped OhioHealth maintain its dominant market position while insulating it from price competition.
OhioHealth is one of the largest healthcare systems in Ohio, spanning 16 hospitals, three joint venture hospitals and more than 200 ambulatory care sites. It has a significant presence in the Columbus region, where regulators say its scale gives it substantial bargaining power over commercial insurers.
The lawsuit comes amid heightened federal scrutiny of hospital consolidation and contracting practices, as lawmakers seek to rein in healthcare costs that continue to rise faster than wages and inflation.
The government is asking the court to block OhioHealth from using the disputed contract provisions and to restore competition in the affected markets.
The health system has denied the allegations, saying that its contracting practices are lawful and benefit patients by ensuring broad access to care.
This type of lawsuit is part of a broader wave of antitrust enforcement targeting hospital consolidation and restrictive contracts nationwide. In recent years, the DOJ and state attorneys general have challenged similar “all-or-nothing” or “full-service” contracting practices in markets from California to Florida, arguing that such terms harm payer competition and increase healthcare prices.
Outcomes in those cases may influence how courts view OhioHealth’s contracts.
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