An antitrust lawsuit filed this week by St. Francis Hospital and Medical Center that accuses its crosstown rival Hartford HealthCare of creating a monopoly on certain services, has once again put the spotlight on industry consolidation, particularly the trend of physician group acquisitions.
State lawmakers last year passed a law that requires the Office of Health Strategy (OHS), which oversees the healthcare industry, to create a working group to study and recommend new regulations for physician practice mergers and acquisitions.
The law requires the 15 to 20 member working group to study all aspects of M&A activity and make preliminary recommendations by early 2023.
The group’s members have been picked and they include representatives from state agencies, health plans, hospitals, physician groups and even consumers.
Their work will take on greater interest in the wake of the St. Francis Hospital lawsuit, which accuses Hartford HealthCare and its subsidiaries, including Hartford Hospital, of trying to create a monopoly on hospital services by acquiring physician networks, particularly cardiologists, and demanding that they refer their patients only to Hartford HealthCare.
The 75-page lawsuit filed in U.S. District Court in New Haven alleges “a campaign of exclusion, acquisition and intimidation” and claims that Hartford HealthCare executives have stated in meetings that their plan was to “crush” or “bury” St. Francis.
The lawsuit claims that Hartford HealthCare, as it has acquired physician practices over the last four years, has threatened and intimidated physicians who don’t comply with its “dictates.”
Hartford HealthCare in a statement said the allegations are without merit and that it would fight them vigorously.
In an interview with HBJ last fall, Office of Health Strategy Executive Director Victoria Veltri raised concerns about limited oversight powers related to physician practice mergers.
She said, by law, any merger involving a group practice with fewer than eight physicians, is not subject to review by her office. Deals involving one physician group acquiring another physician group are also not under OHS purview, she said.
As a result, over a three-year period in Connecticut, OHS had reviewed only three of 55 group practice acquisitions.
“There are current gaps in the system,” Veltri said in October.
Here are the working group’s members:
State Agencies
- Steve Lazarus, OHS
- Ronald Ciesones, OHS
- Rachel Davis, Office of the Atty General
- Marjorie J. Breen, CT Insurance Dept
Health Plans
- Lou Fiorillo, CIGNA
- Theresa Riordan, Anthem
Hospital/Health System
- Leland McKenna, Middlesex Hospital
- Richard Goldstein, NEMG / YNHHSC
- Rod Acosta, MD, Stamford Health
- Jeff Cohen, MD, Hartford Healthcare
- Chris Hyers, UConn Health
- Jean Ahn, Nuvance Health
Specialty Practice
- Dinesh Kapur, MD, ECHO Associates (Eastern CT Hematology/Oncology)
- Robert D. Russo, MD, Russo Radiology
- Atique A. Mirza, MD, Central CT Cardiologists LLC
Large Physician Group
- Rich Almada, ProHealth Physicians
- Lisa Trumble, Southern New England Healthcare Organization
Small Physician Group
- Khuram R. Ghumman, MD, East Granby Family Practice LLC
- Robin Gail Oshman, MD, Private practice
- Michael Steinmetz,Generations Family Health Center (FQHC)
Consumer
- Alan Coker, Retired, past director Intercommunity/ADRC
- Alan Kaye, Retired physician/Cabinet member
