Rhode Island’s two largest nonprofit hospital systems, Lifespan and Care New England, abandoned their merger plans in the face of a joint antitrust challenge from the Rhode Island AG and the FTC. The entities submitted application in February 2021 to state and federal regulators of their plan to merge into an integrated academic health system with Brown University’s medical school. Rhode Island’s insurance commissioner issued a 25-page report warning of the risks to competition and urged strong regulatory oversight.

On February 17, 2022, the Rhode Island AG issued a decision denying the proposed merger, expressing concern that the proposed merger would result in extraordinary market power for the new hospital system and negatively impact healthcare costs, quality and access to care. Simultaneously, the FTC filed an administrative complaint after conducting its own investigation and finding that the merged entity would control at least 70 percent of the markets for inpatient general acute care hospital services and inpatient behavioral health services in Rhode Island. The FTC also voted to file a lawsuit for preliminary injunction in federal court to block the merger, joined by the Rhode Island AG, pending the administrative trial. Less than a week later, the entities withdrew their application and abandoned the proposed merger.