Thread by @MarilynHeineMD

1/ 👉 “After careful consideration and given the significant concerns set forth...⁦@AmerMedicalAssn⁩ respectfully urges the @TheJusticeDept to conduct a thorough examination of the antitrust ramifications of UHG/Optum’s proposed acquisition of CHNG.” tinyurl.com/e2nfztbr

2/ @AmerMedicalAssn writes:

“There is substantial overlap in markets for health information technology (IT)/analytics services that the merging firms supply to health insurers, physicians, and hospitals.”

3/ “Given this overlap and the companies’ large sizes, it is likely that the merging firms have been, or absent the merger would become, substantial head-to-head competitors.”

4/ “The loss of such competition or potential competition could have significant anticompetitive effects on physicians, hospitals, and health insurers.”

5/ “Moreover, the acquisition could also have vertical anticompetitive effects in health IT/analytics, health insurance, physician, and clinical guideline markets.”

“The effects on clinical guideline markets could particularly harm consumers through reduced quality of care.”

6/ AMA notes the merger:

•Involves companies that are large players in Health IT/Analytics and vertically related markets

•Is a horizontal merger that could cause loss of substantial/potential head-to-head competition

•Has vertical ramifications

•Raises physician concerns

7/ Here are a few of the points in the excellent letter by AMA:

“OptumInsight serves nine out of ten U.S. hospitals and more than 100,000 physicians...reports having access to ‘clinical and claims data’ for 250 million insured lives...serves four out of five U.S. health plans.”

8/ Per Change HC, it provides solutions supporting
~2.4K government & commercial payer connections, 1 mil physicians, 125K dentists, 39K pharmacies, 6K hospitals & 700 laboratories...clinical records for over 85 mil unique patients, ~1/4 of the estimated total U.S. population.

9/ “Acquisition of large data stores could enable UHG to harm physicians as it has in the past.”

10/ “Physicians regard the Ingenix case as a cautionary tale about the threat to physicians when third-party payers gain access to large amounts of physician/patient data without express consent.”

11/ “...the 2020 MITRE report states that deidentified data provided by CHNG alone represented more than 50% of private insurance claims in the U.S.”

12/ “...in addition to purely administrative exchanges, CHNG’s Intelligent Healthcare Network also facilitates the exchange of clinical records for ‘over 85 million unique patients, approximately one-quarter of the US population.’”

13/ “OptumInsight alone reports access to ‘clinical and claims data’ for ~250 million insured lives.”

“The acquisition will result in payer control of clinical guidelines, which could harm patients by creating barriers or disruptions to care.”

14/ “With the acquisition, InterQual clinical guidelines will fall under the complete control of the parent company of the largest health insurer in the country.”

15/ @AmerMedicalAssn reviewed this transaction from its “long-standing perspective that competition in health care and related markets is the right prescription for these markets.”

16/ @AmerMedicalAssn writes:

“The purpose of this letter is to identify potential antitrust concerns and to encourage the @TheJusticeDept to conduct a thorough examination of the proposed acquisition.”

👉 Read the letter here: tinyurl.com/e2nfztbr