HCA Healthcare, the second largest health system with six hospitals in the Wasatch Front region of Utah, proposed to acquire five hospitals from Steward Health Care, the fourth largest system in the region.  According to the FTC, the two rival hospital systems vigorously compete with each other to keep costs down. The proposed merger is likely to substantially lessen competition for general acute care services in healthcare markets of at least four counties that are already high concentrated. Specifically, the merger would increase the Herfindahl-Hirschman Index (“HHI”) by more 200 points to 2,500, which is presumptively unlawful. Additionally, the acquisition would eliminate Steward as a low-cost provider and give HCA greater bargaining power with insurers to demand higher reimbursement rates, which would be passed on to consumers in the form of increased premiums, deductibles, co-pay, and out-of-pocket expenses.

Along with the administrative complaint, the FTC filed suit in the District Court of Utah for a preliminary injunction against the merger pending the administrative trial scheduled for December. The parties also stipulated to the court’s entry of a temporary restraining order that would prevent the entities from consummating the transaction until after the court rules on the motion for preliminary injunction.