At first blush, the structure of the deal doesn’t pose any obvious antitrust concerns, according to Tim Greaney, a former DOJ health care antitrust attorney who teaches at UC Law San Francisco. There’s a chance it could help large national employers that want more insurance and provider choices beyond the main national insurance carriers, he said.

However, problems could arise if Kaiser uses Risant as a way to negotiate new types of “all-or-nothing” contracts, which occur when hospitals force insurers to include all facilities in the insurance network regardless of price. Additionally, regulators may want assurances that Kaiser won’t impose a Hobson’s choice on independent physicians, who could be hurt if they are “facing a gun to their head because they can either be employed or have no business,” Greaney said.