Dive Brief:
- Health First, an integrated health system in central Florida, reached a settlement with plaintiffs who were seeking nearly $350 million in damages in a federal antitrust lawsuit.
- Plaintiffs included OMNI Healthcare, the Interventional Spine Institute of Florida, a group of physicians and a physician’s assistant, who accused Health First of creating an illegal monopoly and pressuring them into referring patients exclusively to Health First hospitals and specialists.
- The settlement was announced just one day after the trial began, ending a 3-year-long legal battle between Health First and the plaintiffs. However, Health First faces similar allegations in state lawsuit brought by a public hospital in Titusville, FL.
Dive Insight:
In the federal antitrust lawsuit pitting Health First against a group of Florida physicians, a settlement was announced just one day after opening statements were made. The settlement ends a three-year-long legal battle over Health First’s market control, although it surely isn’t the last as an increasing numbers of integrated health systems bring hospitals, physicians and health plans under one umbrella.
Allegations against Health First stemmed from its 2013 acquisition of Melbourne Internal Medicine Associates, a large physician group operating in Brevard County, FL. Plaintiffs argued this move created an illegal monopoly that decreased competition. During opening statements, Richard Arnold, an attorney for the plaintiffs, explained that Health First controlled 86% of acute hospital services, 27% of physicians and 14.4% of health insurance in the local market.
Health First used its market control to unfairly influence referral patterns by pressuring physicians to refer patients almost exclusively to Health First hospitals and specialists, according to allegations. Those who didn’t play along lost admitting privileges to Health First hospitals and were denied contracts with Health First health plans. “It is thus impossible to meaningfully participate in any healthcare-related market in Southern Brevard County without doing business with Health First and, more importantly, on Health First’s terms,” plaintiffs claimed.
Details of the settlement have not been released, although financial claims against Health First have been settled. Plaintiff OMNI Healthcare also issued a statement declaring, “The plaintiffs and Health First have agreed to mediate a number of non-financial demands in an effort to improve healthcare in Brevard County.”
Health First is no stranger to complaints that it engages in unfair business practices. It won an earlier lawsuit brought by OMNI Healthcare in 2008 and the most recent antitrust lawsuit was dismissed twice before proceeding to trial.