The Federal Trade Commission submitted a Sept. 5 comment to the Indiana Department of Health urging it to reject an application for Terre Haute, Ind.-based Union Health to acquire Terre Haute Regional Hospital, part of Nashville, Tenn.-based HCA Healthcare.
Union Health and Terre Haute Regional have proposed to merge under a certificate of public advantage, which could protect the merger from antitrust scrutiny and lead to a deal that "would likely impose higher costs and could lead to worse healthcare outcomes for Indiana patients, as well as lower wage growth for hospital workers," the FTC said in a Sept. 5 news release. The parties filed a COPA application to merge in September 2023.
"Union Health has worked diligently to provide comprehensive data and documentation to IDOH, illustrating the potential positive impacts of the merger," a Union Health Sept. 5 statement shared with Becker's said. "The merger is not merely a business transaction; it is a strategic effort to improve health care delivery in our community."
COPA laws have been enacted in more than a dozen states. Indiana's COPA law requires hospitals to be located in predominantly rural counties with a population of 140,000 people or less. In addition, the county cannot be contiguous to another county with a population of more than 250,000.
"Union Health’s proposed acquisition of Terre Haute Regional raises substantial risk of serious competitive harm and there is insufficient evidence to conclude that the potential harms from the merger would outweigh the claimed potential benefits," the FTC said.
The FTC found that Union Health and Terre Haute Regional are financially stable and could operate on their own without the merger. The FTC's analysis also found the merger would "likely depress wage growth for registered nurses due to increased employer consolidation."
Union Health disagreed and issued a statement saying that the merger represents an "innovative solution" in "overcoming persistent health disparities" in the area.
"The health challenges faced by our residents require a tailored approach and the proposed merger is a critical step forward in addressing these needs," the Union Health statement said. "As IDOH continues its thorough review of the proposed agreement, it is imperative that all voices are heard and the unique context of our community is taken into account."
A spokesperson for IDOH told Becker's Sept. 5 that it is still reviewing applications and plans to take all comments from the public into consideration.