American Hospital Association
February 24, 2022
The American Hospital Association commends the Department of Justice for its efforts to protect patients and providers, including hospitals and health systems, from United HealthGroup’s (UHG) attempt to acquire Change Healthcare. The AHA urged DOJ’s Antitrust Division to conduct a thorough investigation of the proposed transaction because of its anticompetitive potential to “produce a massive consolidation of competitively sensitive health care data” under UHG’s exclusive control. We warned repeatedly “the combination of the parties data sets would impact (and likely distort) decisions about patient care and claims processing and denials to the detriment of consumers and health care providers….” Challenging this proposed combination was the right thing to do to prevent untold competitive harm for patients and health care providers.
Had DOJ allowed this transaction to move forward it would have permitted a massive concentration of sensitive health care data in the hands of a single, powerful owner with an inherent conflict of interest. There is every indication that it is Change Healthcare that constrains UHG’s largest subsidiary’s (Optum) ability to prejudice payment accuracy in favor of its own financial outcomes by means of increased patient payment denials and coverage restrictions. And, allowing Optum the opportunity to own and then manipulate Change’s proprietary evidence-based clinical support criteria (InterQual) also would have allowed UHG to build its corporate profits by increasing patient claim denials.