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Connecticut Inside Investigator
Hartford Healthcare: Monopoly, price fixing alleged in Teamsters lawsuit
By Marc E. Fitch,
2024-06-25
A lawsuit filed in federal court by the Estuary Transit District, and the Teamsters 671 Health Service and Insurance Plan out of Bloomfield, against Hartford Healthcare (HHC) alleges the massive healthcare system is a monopoly engaged in price-fixing and other anti-competitive practices that drive up the overall cost of healthcare.
The complaint filed on June 14, 2024 , alleges “monopolization, restraint of trade, and price fixing,” against one of Connecticut’s largest healthcare systems, saying HHC and its network of providers “have engaged in a continuing scheme to suppress competition and inflate prices for healthcare services,” and is seeking class-action status.
“Beginning no later than June 2020 and continuing until the present, Defendants have abused their market power 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,” the complaint says.
Among the allegations of reducing competition, the complaint says HHC imposes “all or nothing” conditions on payers; imposes anti-tiering and anti-steering provisions in contracts; coerces physician practices to become ICP Providers; and traps referrals within the ICP network “by forcing physicians to refer exclusively or nearly exhaustively to Defendants’ facilities.”
The complaint goes on to compare service costs between HHC and other hospitals, saying a colonoscopy at HHC’s St. Vincent’s Hospital costs $3,800, compared to $1,400 at Bridgeport Hospital; the same procedure costs $2,200 at HHC’s Hartford Hospital, while St. Francis is $1,800. The lawsuit also compared the cost of emergency room visits, alleging that HHC ER visits were 50 percent higher than St. Francis Hospital.
“But for the unlawful conduct complained of herein, Defendants would be unable to charge such supracompetitive prices,” the complaint states.
The complaint also notes that HHC dominates Connecticut’s geographic regions, controlling roughly 50 to 80 percent of healthcare services in districts like Hartford, Bridgeport, Torrington, Willimantic, and Meriden, including specialist outpatient services.
“If a commercial health plan wants to offer a viable product that it can market to either insureds or self-insured plans in or near those regions in Connecticut, it has no choice but to include those ‘must have’ hospitals in its network irrespective of the price or quality of the GAC services they offer,” the lawsuit says.
The lawsuit goes on to cite national healthcare cost statistics, indicating that the United States pays more than other developed countries.
Healthcare costs and rising insurance rates in Connecticut are recurring issues before the legislature with few solutions forthcoming that lawmakers can agree on to help lower costs. And while Connecticut has a certificate of need (CON) process in place that attempts to ensure that hospital mergers and acquisitions result in better and more cost-efficient care, consolidation of hospital and healthcare services has driven up prices, according to a 2024 OHS report .
“Consolidation in Connecticut that occurred between 2013 and 2019 increased market power for hospitals and systems in seven of the nine regions from 2016 to 2021. Hospitals that gained market power increased prices for health care services faster than comparison hospitals in the rest of the State,” the OHS report concluded. “This faster price growth occurred for both inpatient and outpatient services. Hospitals with greater market power also had faster relative growth in the number of high-profit services (cardiac and musculoskeletal care), while slower growth in less profitable services like childbirth and behavioral health care services.”
The OHS report lists HHC’s affiliation with Backus Hospital in 2013, a partnership with Charlotte Hungerford in Torrington in 2017, and its acquisition of St. Vincent’s in 2019 as leading to “increased market power.”
A report by KFF in 2024 found that healthcare consolidation leads to higher prices, particularly among hospitals, but it is unclear if those price increases result in better care or more healthcare access. The report also notes that it can be difficult to break up mergers, anti-trust litigation is expensive and difficult, and that anti-trust agencies are often behind the times.
Reached for comment via email, Hartford Healthcare Senior Director of Media Relations Tina Varona says they will defend themselves against the allegations, “which fundamentally misrepresent the many ways Hartford HealthCare is working to transform healthcare, including through increased accessibility and lower-cost options.”
“Now, as always, we remain focused on serving the needs of our patients and our communities,” Varona continued.
St. Francis Hospital also filed a similar federal lawsuit against HHC in 2022, alleging HHC was a monopoly and claiming a “campaign of intimidation” against St. Francis Hospital, according to CT Mirror . That lawsuit remains ongoing.
The recent lawsuit by the Teamsters asks the court to find the HHC has monopolized the market, unlawfully restrained trade, award the plaintiffs and class members “threefold damages determined to have been sustained by them, attorney fees and expenses, and to enjoin HHC from “seeking, agreeing to, or enforcing any provision in any agreement that prohibits or restricts competition,” as described in the complaint.
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