Overview
Hartford HealthCare Corporation (“HHC”) is a dominant hospital provider in Connecticut that serves 500 locations in 185 towns and cities across Connecticut and generates over $5 billion in revenue per year.
Plaintiffs Estuary Transit District and Teamsters 671 Health Service & Insurance Plan, on behalf of themselves and others, allege that HHC and certain of HHC’s subsidiaries, including Hartford Hospital, the largest hospital in Hartford; Hartford HealthCare Medical Group, Inc., HHC’s network of outpatient providers; and Integrated Care Partners (“ICP”), HHC’s network of purportedly “independent” healthcare providers, unlawfully monopolize, restrain trade, and engage in price fixing in the Connecticut inpatient and outpatient health services markets in violation of the Sherman Act.
Key Dates & Rulings
- On October 23, 2024, the Honorable Michael P. Shea granted Plaintiffs’ unopposed leadership motion and appointed Cohen Milstein as Interim Co-Lead Class Counsel.
- On June 14, 2024, Cohen Milstein filed an antitrust class action in the U.S. District Court of the District of Connecticut.
Case Background
Healthcare markets operate differently than the markets for many consumer goods and services. This is because the individuals who choose the services to be provided (typically, the patient and/or provider) are different than the entities that pay directly for the services (typically, the health plan). Thus, price competition typically comes in the form of providers competing to be included in a “network” offered by a health plan. Those providers that offer lower prices to be included in the network then typically get more patients because the health plan, in turn, will steer its members or enrollees (i.e., patients) to “in network” providers. The health plans then market their networks to customers (e.g., employers, insurers) that pay for some proportion of the health services ultimately used by the insured members or enrollees. To be marketable, networks must offer a comprehensive range of inpatient and outpatient providers and facilities.
Plaintiffs claim that beginning no later than June 2020 and continuing until the present, Defendants have abused their market power in the inpatient and outpatient to carry out a multifaceted anticompetitive scheme with the purpose and effect of foreclosing healthcare competition and extracting supracompetitive prices from Plaintiffs and other health plans. Defendants’ scheme includes at least the following:
- Imposing “all or nothing” conditions on payers by requiring health plans who want to include certain must-have facilities or providers in their networks to include all or substantially all of Defendants’ facilities, thereby preventing health plans from assembling more cost-effective provider networks;
- Imposing anti-tiering and anti-steering provisions in HHC’s contracts with health plans that prevent those health plans from incentivizing their members to seek healthcare from lower cost providers;
- Coercing physician practices to become ICP providers and then imposing de facto exclusive contracts which prevent them both from joining networks that could compete against Defendants and from negotiating separately with health plans; and
- Trapping referrals within the ICP network by forcing physicians to refer exclusively or nearly exclusively to Defendants’ facilities and threatening to cut off physicians who do not refer exclusively to Defendants.
Defendants’ scheme has substantially foreclosed competition in both general acute care inpatient hospital services and outpatient medical services in several distinct geographic markets within Connecticut. This, in turn, has artificially inflated healthcare costs and prices paid by Plaintiffs and the proposed Class while also impairing the quality of the services provided, thus injuring Plaintiffs and the proposed Class.
Plaintiffs bring this action on behalf of themselves and other health plans to enjoin Defendants’ ongoing anticompetitive conduct and to recover damages for the injuries they have sustained as a result of Defendants’ artificially inflated prices.