Yost, DOJ accuse OhioHealth of antitrust violations in new lawsuit

• The Ohio Attorney General and the U.S. Department of Justice are suing OhioHealth, alleging antitrust violations.
• The lawsuit alleges that OhioHealth uses its market dominance to make health insurance more expensive.
• OhioHealth is accused of restricting insurance companies from offering more budget-friendly health plans.
• The legal action seeks to stop these practices, which plaintiffs allege harm competition from other hospital systems.

Editor’s Note: This story has been updated to add new information.

The Ohio Attorney General and the U.S. Department of Justice have sued OhioHealth Corp., accusing one of central Ohio’s biggest health care providers of violating antitrust laws and making insurance more expensive.

The lawsuit was filed Feb. 20 in the U.S. District Court for the Southern District of Ohio in Columbus.

In the lawsuit, the state Attorney General, Dave Yost, and the DOJ allege that the hospital system has cornered the market on providing care – more than 35% of general acute care beds in Franklin and Delaware counties – and has restricted insurance companies from offering budget-friendlier options.

OhioHealth operates 13 hospital and standalone emergency rooms in the two counties, as well as more than 200 affiliated doctors offices, rehabilitation centers and clinics. Those facilities include Grant Medical Center and Riverside Methodist Hospital.

OhioHealth said in a statement that the corporation has been cooperating with a DOJ review of its managed care agreements.

“We are confident in our position and remain committed to full compliance with all applicable laws and regulatory requirements,” the statement said.

OhioHealth said it would not comment further on the pending litigation.

The lawsuit alleges that OhioHealth’s size and share of the health care marketplace in central Ohio makes it impossible for an insurance provider to not include OhioHealth in at least some of its provider networks. In other parts of Ohio, an OhioHealth facility is the only health care option in the county.

“As a result of this reduced competition … individuals and employers in the Columbus area pay higher prices for health insurance coverage and have fewer insurance plans from which to choose,” the lawsuit says.

OhioHealth uses this power to put restrictions in contracts with insurance companies that the lawsuit alleges prevents them from offering “budget-conscious plans.”

“Payors that sell commercial health insurance plans … have tried to negotiate the removal of these restrictions from their contracts with OhioHealth but OhioHealth has summarily refused,” the lawsuit says. “In the absence of these contractual restrictions, payors would be free to offer budget-conscious plans that allow patients to save money by choosing high quality and cost-effective hospitals.”

OhioHealth’s restrictions “short circuit the competitive process” and hurt the ability of other hospital systems like Mount Carmel and Ohio State University to expand their patient base, the lawsuit alleges.

“OhioHealth’s rivals are impeded in their efforts to win more commercially insured business by offering lower prices or higher value,” the lawsuit says. “Denied the ability to attract new patients … non-dominant rivals lose the opportunity to demonstrate what they offer to patients and to build their reputation and consumer loyalty. This in turn deprives them of the larger patient volume that could make new investments in services viable, further hurting patients.”

The lawsuit asks a federal judge to find that OhioHealth’s practices violate both federal and state antitrust legislation and to prevent the hospital system from doing anything similar in the future.

Reporter Bethany Bruner can be reached at bbruner@dispatch.com.