On February 20, 2026, the Department of Justice (DOJ) and the Ohio Attorney General’s office filed suit against OhioHealth, a 16-hospital nonprofit health system, claiming that OhioHealth’s use of all-or-nothing terms (requiring insurers to include all of its providers in their networks) inflates costs for policyholders and disadvantages competitors.  The suit also claimed that OhioHealth’s contracts included terms requiring OhioHealth to be at the most-favored level of benefits in each network, and that payors were prevented from providing patients with price information about healthcare services.  The Source published an analysis of this case in March. […]

Across the healthcare system, companies that once occupied a single layer of the supply chain increasingly own the layers above and below them, and that vertical consolidation can raise costs, narrow patient choice, and create conflicts of interest when one firm both sets prices and competes in the market it is pricing.  Pharmacy benefit managers (PBMs) are a prime example of the potential for harms created by vertical consolidation.  A PBM sits between health plans and pharmacies and determines how much the pharmacy is reimbursed when it dispenses a drug, […]

On Tuesday, April 7, 2026, the 9th U.S. Circuit Court of Appeals struck down key provisions of California’s Assembly Bill 290 (2019), a law that capped the reimbursement rates dialysis providers could collect from private insurers for patients receiving premium assistance from charitable organizations and required related patient disclosures. The court held that the reimbursement cap and disclosure provisions violated the First Amendment by burdening the American Kidney Fund’s right to associate with dialysis providers DaVita and Fresenius, and that California had not narrowly tailored the law to its asserted […]

On February 10, 2026, California Governor Gavin Newsom signed SB 25 into effect, enacting the California Uniform Antitrust Premerger Notification Act.  Introduced by Senator Tom Umberg, the new law mandates that companies required to file federal premerger notifications under the federal Hart-Scott-Rodino (HSR) Act also file the information with the California Attorney General.  California is following Washington and Colorado in enacting a version of the Uniform Antitrust Premerger Notification Act, model legislation proposed by the Uniform Law Commission.  Although the new law gives no new enforcement powers, it expands the […]

In mid-March 2026, Sutter Health and Allina Health announced the signing of a Letter of Intent to merge the healthcare systems.  Sacramento-based Sutter Health has more than 600 locations and 27 hospitals, and reported $19.8 billion in total revenue and $509 million in operating income in 2025.  Sutter Health has come under fire in recent years with claims that it has improperly used its market power to impose anticompetitive contract terms, restricting competition and driving up the cost of care.  Minneapolis-based Allina Health has 12 hospitals and 100 additional care […]

Antitrust and Market Competition Playing Favorites — State Protection of Academic Medical Centers from Antitrust Oversight New England Journal of Medicine Jaime S. King, Katherine L. Gudiksen, Anna D. Sinaiko The authors explore a new trend with U.S. academic medical centers (AMCs) merging with nonacademic hospitals and health care systems.  These mergers pose risks of price increases and other competitive harms.  Regulators should review all transactions involving an AMC and ensure that any promised benefits from consolidation do not harm the public.  Notably, at least four states have laws explicitly […]

The Source’s founder Jaime S. King, and executive editor Katherine L. Gudiksen, working with Harvard’s Anna D. Sinaiko, have authored a report on state antitrust exemptions for academic medical centers (AMCs) published recently by the New England Journal of Medicine.  There is a recent history of AMCs merging with nonacademic systems, with states creating “carve-outs” to exempt AMCs from antitrust oversight.  The research indicates that such exemptions are unwise and that states should engage in reviews of AMC transactions to ensure they actually deliver public benefits while minimizing consumer harm.  Read the full paper here: https://www.nejm.org/doi/full/10.1056/NEJMp2514565

Background In August of last year, The Source shared information about the California Law Revision Committee’s (CLRC) antitrust study, spurred by the 2022 Assembly Concurrent Resolution No. 95. At its outset, the study aimed to address the U.S. monopoly problem and the “threat of market concentration” in California.  The legislature tasked the CLRC with determining the following: Whether California antitrust law should align itself with Section 2 of the Sherman Act, outlawing monopolies by single corporations in California? Whether California antitrust law should be specifically modified with respect to technology […]

Healthcare Markets and Acquisitions Health Insurance After Corporatization —What Next? New England Journal of Medicine Perspective Leemore Dafny, Ph.D. The author explores whether the corporatization of the U.S. health insurance industry (i.e., the consolidation of insurers within and across markets) contributes to the industry’s poor performance among the commercially insured population. The answer is maybe. One key driver of such consolidation is the “technology of insurance.” Economies of scale drive insurance consolidation by lowering costs and stabilizing risk for larger insurers, but beyond a certain size, these advantages fade, and […]

On Thursday, February 5, a federal jury ordered Medtronic to pay $381.7 million to Applied Medical for antitrust violations, finding that Medtronic used its market power to illegally stifle competition through bundling and exclusive-dealing contract terms. Parties to the Case Both Medtronic and Applied Medical produce a surgical instrument called an advanced bipolar device (ABD), which uses electrical current to cut tissue and seal blood vessels during surgery.  Medtronic is the largest medical device supplier in the world.  Medtronic has a dominant market share in the ABD market while Applied […]