Dive Brief:
- The Justice Department is suing OhioHealth for allegedly forcing insurers into anticompetitive contracts and driving up healthcare prices for Ohio patients.
- The DOJ filed a lawsuit last week accusing the regional nonprofit system of leveraging its market power to force insurers to include its providers in their networks. This restricts insurers from offering differently priced plans that include or exclude certain OhioHealth providers, the DOJ alleges.
- As a result, OhioHealth charges “significantly higher” for healthcare services than other systems in the Columbus metropolitan area, without a corresponding increase in quality, according to the lawsuit.
Dive Insight:
OhioHealth is a major health system in Ohio, with 16 hospitals in addition to outpatient facilities, physician groups and other clinics. But the system is especially dominant in the Columbus area, where it is based.
Although it competes with other providers, including Ohio State University Wexner Medical Center and Trinity Health-owned Mount Carmel Health System, OhioHealth controls more than 35% of inpatient acute care hospital beds in the Columbus metropolitan market, the DOJ found.
OhioHealth’s market share is “notably greater” than the system’s next largest competitor, according to credit ratings agency Fitch Ratings.
OhioHealth’s control of the market allows it to negotiate anticompetitive contracts with insurers, the DOJ alleges. Because of OhioHealth’s size, insurers offering plans in the Columbia area have no choice but to include OhioHealth in their networks.
Commercial insurers typically offer a selection of plans priced based on the providers included in a network. Higher priced plans generally correspond to a broader network of providers, but consumers can also choose cheaper plans with more restrictive networks.
By forcing insurers to include all OhioHealth providers, OhioHealth diminishes competition, because the system isn’t incentivized to lower prices or compete with other hospitals on quality to be included in a plan, the DOJ alleged.
That interrupts the “virtuous cycle” of competition among providers, the DOJ said in its suit.
“Competition for healthcare is vital to all Americans,” Omeed Assefi, acting assistant attorney general of the DOJ’s antitrust division, said in a statement. “These restrictions cause many Columbus residents to pay more for lower-quality healthcare.”
OhioHealth has been cooperating with the Justice Department and remains “committed to full compliance with all applicable laws and regulatory requirements,” a spokesperson for the health system said. They declined to comment on the specifics of the case.
Unlike other nonprofit health systems, OhioHealth has recently enjoyed relatively high operating margins. The health system recorded a 10% margin with 548 days of cash on hand in its 2025 fiscal year. Individual nonprofit hospitals had an average margin of 1.1% in 2025, with about 215 days cash on hand, according to Fitch Ratings.
