Aug 11, 2021 - Health

HCA hospital gets hit with a data-driven antitrust lawsuit

Illustration of a hospital with a dollar sign

Illustration: Lazaro Gamio/Axios

A class-action lawsuit filed yesterday against HCA's health system in western North Carolina — which was known until recently as Mission Health — lays out a textbook case against hospital consolidation and monopoly pricing power.

Why it matters: Neither hospital monopolies nor antitrust lawsuits are anything new, but the new federal regulation requiring hospitals to post their prices — — including negotiated rates — could make such lawsuits more common going forward.

The lawsuit argues that patients in the hospital system's service area are charged higher rates and subsequently pay more in premiums than the rest of the state.

  • The lawsuit uses an unidentified "large commercial claims dataset" to give specific examples of hospital services that have become more expensive over time and are significantly higher than the average prices across the rest of the state.
  • It alleges that HCA is able to use its monopoly power and anti-competitive negotiation tactics to obtain these high prices.
  • Hospitals have been slow to comply with the new price transparency rules, and the lawsuit alleges that HCA is among those that has "refused to fully comply."

What it says: "Were HCA to comply and reveal to consumers and regulators the true prices that it charges, the public would know that HCA/Mission’s prices for key services are by far the highest in North Carolina," it alleges.

  • "For instance, according to a large commercial dataset, HCA currently charges more than two times the state average for a C-Section without complications. This price disparity—one matched and exceeded by numerous other procedures—can only exist because of the system’s unbridled monopoly power and its status as a 'must have' system in Western North Carolina."

The other side: "Once we have been served with the lawsuit, we will respond appropriately through the legal process," said Nancy Lindell, a Mission Health/HCA Healthcare NC Division spokesperson. 

  • "We are committed to caring for Western North Carolina as demonstrated through more than $330 million in Charity Care and uninsured discounts we provided in 2020, expansion of hospital services including the opening of the North Tower, a new Pediatric ER, and securing land for a new 120-bed behavioral health hospital."

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