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The Optum-Atrius Transaction: A Model for Reviewing Mid-Sized Health Transactions

Published online by Cambridge University Press:  17 March 2022

Abstract

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Type
Recent case developments
Copyright
© 2022 The Author(s)

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References

1 Michael F. Furukawa et al., Consolidation of Providers Into Health Systems Increased Substantially, 2016-18, 39:8 Health Affairs 1321, 1321-23 (2020).

2 Lovisa Gustafsson & David Blumenthal, The Pandemic Will Fuel Consolidation in U.S. Health Care, Harvard business review (Mar. 9, 2021), https://hbr.org/2021/03/the-pandemic-will-fuel-consolidation-in-u-s-health-care.

3 Fed. Trade Comm’n, HSR Threshold Adjustments and Reportability for 2021, The Fed. Trade Commn: Competition matters (Feb. 17, 2021 5:19PM), https://www.ftc.gov/news-events/blogs/competition-matters/2021/02/hsr-threshold-adjustments-reportability-2021.

4 Alexandra D. Montague et al., State Action to Oversee Consolidation of Health Care Providers, Milbank Memorial Fund (Aug. 2021) https://www.milbank.org/wp-content/uploads/2021/08/State-Action-to-Oversee-Consolidation_ib_V3.pdf.

5 Id.

6 Barbara Anthony, Beyond Obamacare: Lessons from Massachusetts (Mossavar-Rahmani Ctr. For Bus. and Gov’t, Working Paper No. 82, 2017), https://www.hks.harvard.edu/sites/default/files/centers/mrcbg/files/82_BeyondObamcare_fixed.pdf; Massachusetts health policy commission, https://www.mass.gov/orgs/massachusetts-health-policy-commission (last visited Nov. 20, 2021).

7 Anthony, supra note 6, at 6.

8 Anthony, supra note 6, at 6; See also Health Care Cost Growth Benchmark, https://www.mass.gov/info-details/health-care-cost-growth-benchmark (last visited Nov. 20, 2021); Health Policy Commission; Governing Board; Members; Duties and Power; Annual Report, 6D M.G.L.A. §2 (Jan. 1. 2021)[hereinafter HPC].

9 HPC, supra note 8.

10 Anthony, supra note 6, at 6; HPC, supra note 8.

11 Lisa Waugh & Douglas McCarthy, Case Study: How the Massachusetts Health Policy Commission is fostering a statewide commitment to contain health care spending growth (Mar. 2020), https://www.commonwealthfund.org/publications/case-study/2020/mar/massachusetts-health-policy-commission-spending-growth.

12 Public Hearings; Witnesses; Annual Report, 6D M.G.L.A. §8 (Jan. 1, 2021).

13 Waugh supra note 11.

14 Morgan Haefner, Optum Expect to Add 10,000 Physicians This Year, Beckers Hosp. Rev. (Jan. 21, 2021), https://www.beckershospitalreview.com/payer-issues/optum-expects-to-add-10-000-physicians-this-year.html.

15 Laura Dyrda, Optum on Track to Exceed Physician Hiring Goal, CEO Says, Beckers ASC Rev. (Apr. 15, 2021), https://www.beckersasc.com/asc-news/optum-on-track-to-exceed-physician-hiring-goal-ceo-says.html.

16 Mass. Dep’t of Public Health, Determination of Need Application Form: Reliant Medical Group, Inc. (2014)[hereinafter Mass. Dep’t of Public Health], https://www.mass.gov/doc/reliant-medical-group-inc-asc-application-form/download.

17 Id.

18 Jeff Byers, Optum a Step Ahead in Vertical Integration Frenzy, Healthcare Dive (Apr. 12, 2018), https://www.healthcaredive.com/news/optum-unitedhealth-vertical-integration-walmart/520410/.

19 Bruce Japsen, Optum to Provide More Than Half of UnitedHealth’s 2020 Profits, Forbes (Dec. 3, 2019), https://www.forbes.com/sites/brucejapsen/2019/12/03/optum-to-provide-more-than-half-of-unitedhealths-2020-profits/?sh=5f4499034959.

20 Susan Morse, OptumCare Acquires Reliant Medical Group in Massachusetts, Health Care Finance News (Apr. 6, 2018), https://www.healthcarefinancenews.com/news/optumcare-acquires-reliant-medical-group-massachusetts.

21 Morse, supra note 20; See also Morgan Haefner, UnitedHealth’s Optum Completes Acquisition of Reliant Medical Group for $28M, Beckers Hosp. Rev. (Apr. 4, 2018), https://www.beckershospitalreview.com/hospital-transactions-and-valuation/unitedhealth-s-optum-completes-acquisition-of-reliant-medical-group-for-28m.html.

22 Mass. Dep’t of Public Health, supra note 16.

23 Morse, supra note 20.

24 Haefner, supra note 21.

25 Morgan Haefner, Optum, Atrius Health Deal: 9 Numbers to Know, Beckers Hosp. Rev.: Payer Issues (Mar. 8, 2021), https://www.beckershospitalreview.com/payer-issues/optum-atrius-health-deal-9-numbers-to-know.html.

26 Priyanka Dayal McCluskey, Physicians Group Atrius Health Plans to Join Optum, Giving a National Operation a Bigger Mass. Presence, Boston Globe (Mar. 2, 2021), https://www.bostonglobe.com/2021/03/02/business/physician-group-atrius-plans-acquisition-by-optum/.

27 Mass. Health Pol’y Comm’n, Board Meeting-June 24, 2021, YouTube (Jun. 24, 2021)[hereinafter Mass. Health Pol’y Comm’n], https://www.youtube.com/watch?v=8C-ds0TFfYk.

28 Montague et al., supra note 4.

29 Mass. Health Pol’y Comm’n, supra note 27.

30 Id.

32 Id.

33 Id.

34 Id.

35 Id.

36 Id.

37 Id.

38 Id.

39 Id.

40 Id.

41 Id.

42 Mass. Health Pol’y Comm’n, supra note 27.

43 Mass. Health Pol’y Comm’n, Information About Material Change Notices/Cost and Market Impact Reviews, https://www.mass.gov/service-details/information-about-material-change-noticescost-and-market-impact-reviews (last visited Nov. 20, 2021).

44 Id.

46 Id.

49 Id.

50 Med. Grp. Mgmt. Ass’n. Staff Members, Deal or No Deal: COVID-19’s Impact on the Pace of Consolidation in Healthcare, MGMA STAT, (July 14, 2021)[hereinafter Med. Grp. Mgmt. Ass’n.], https://www.mgma.com/data/data-stories/deal-or-no-deal-covid-19%E2%80%99s-impact-on-the-pace-of-c.

51 Id.

52 Id.; Carol K. Kane, Recent Changes in Physician Practice Arrangements: Private Practice Dropped to Less Than 50 Percent of Physicians in 2020, American Medical Association Policy Research Perspectives, 1 (2021), https://www.ama-assn.org/system/files/2021-05/2020-prp-physician-practice-arrangements.pdf.

53 Med. Grp. Mgmt. Ass’n., supra note 45.

54 Nathan Eddy, Nearly 70% of U.S. Physicians are Employed by Hospitals or Corporate Entities, Healthcare Finance (Jul. 13, 2021), https://www.healthcarefinancenews.com/news/nearly-70-us-physicians-are-employed-hospitals-or-corporate-entities.

55 Id.

56 Med. Grp. Mgmt. Ass’n., supra note 45.

57 Susan Morse, Biden Executive Order Targets Healthcare Consolidation, Healthcare FINANCE (Jul. 9, 2021), https://www.healthcarefinancenews.com/news/biden-executive-order-targets-healthcare-consolidation.

59 R.I. Exec. Order No. 19-03 (Feb. 6, 2019), https://governor.ri.gov/executive-orders/executive-order-19-03.

60 Conn. State Off. of Health Strategy, Cost Growth and Quality Benchmarks, and Primary Care Target, Conn. State (Last visited Nov. 20, 2021); see also Comm. On Health Care S.B. 889, 80th Legis. Assemb., Reg. Sess. (Or. 2019), https://www.oregon.gov/oha/ERD/Pages/OregonPassesBipartisanLegislationToSlowRisingCostOfHealthCareAndIncreaseTransparencyForConsumers.aspx.

61 Conn. Exec. Order No. 5 (Jan. 22, 2020), https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Lamont-Executive-Orders/Executive-Order-No-5.pdf; Conn. State Off. of Health Strategy supra note 54.

62 Wash. State Med. Ass’n, Input Needed on Health Care Cost Transparency Board Benchmarks (Oct. 8, 2021), https://wsma.org/Shared_Content/News/Membership_Memo/2021/October_8/input_needed_on_health_care_cost_transparency_board_benchmarks; see also Health Care Cost Transparency Board, H.B. 2457, 66th Legis. Assemb., Reg. Sess. (Wash. 2020), https://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Session%20Laws/House/2457-S2.SL.pdf?q=20200727153325.

63 N.J. Exec. Order No. 217 (Jan. 21, 2021), https://nj.gov/infobank/eo/056murphy/pdf/EO-217.pdf; Rutgers Ctr. For State Health Pol’y, New Jersey Develops Health Care Cost Growth Benchmark Program, Institute for Health, Health Care Policy and Aging Research, http://www.cshp.rutgers.edu/content/nj-benchmark-program (last visited Nov. 20, 2021).

64 Cal. Health & Human Services, Governors Budget Summary 2021-2022 (2021), http://www.ebudget.ca.gov/2021-22/pdf/BudgetSummary/HealthandHumanServices.pdf; Cal. Dep’t of Health Care Access and Info., Get the Facts About the Proposed Office of Health Care Affordability at OSHPD (Feb. 24, 2021), https://hcai.ca.gov/get-the-facts-about-the-proposed-office-of-health-care-affordability-at-oshpd/.

65 Joel Ario et al., State Benchmarking Models: Promising Practices to Understand and Address Health Care Cost Growth, Manatt Health (June 2021), https://www.manatt.com/Manatt/media/Documents/Articles/RWJF_State-Benchmarking-Models_June-2021_i_FOR-WEB.pdf.