Abstract
The healthcare industry has become highly concentrated due to increased rates of consolidation. Mergers and acquisitions among healthcare providers have become extremely common, making dominant hospital systems the norm. When healthcare provider markets are highly concentrated, competition deteriorates, leaving patients to suffer the consequences: higher prices for lower quality care.
The federal antitrust agencies tasked with preserving competition have failed to combat the consolidation trends that are plaguing the healthcare industry. Vertical consolidation between hospitals and physician groups has especially gone unchecked. The Hart-Scott-Rodino Act, a federal antitrust law, requires merging parties to give the agencies pre-merger notice. This law, however, requires notice of only the largest transactions. Because most vertical hospital-physician acquisitions are too small to require reporting, hospitals and hospital systems can conduct several acquisitions without drawing attention from the antitrust enforcement agencies. As a result, hospital systems are able to gradually and quietly amass market power, thereby obtaining the leverage to increase prices, reduce innovation, and offer lower quality care. This is the process of “stealth consolidation.”
This Note examines the types of mergers and acquisitions that occur between healthcare providers. It then explains why antitrust enforcement in this industry has been insufficient and how acquiring parties have been able to successfully pull off stealth consolidation. This Note concludes by providing methods to address stealth consolidation and preserve patients’ access to affordable, quality healthcare.
Recommended Citation
Nathan Rush, Stealth Consolidation: Healthcare’s Process of Quietly Dodging Antitrust Enforcement, 83 Wash. & Lee L. Rev. Online 192 (2026), https://scholarlycommons.law.wlu.edu/wlulr-online/vol83/iss3/1