UnitedHealth and Change Healthcare — Why We’re Saying “NO” and You Should Too

In the world of Big Healthcare mergers and acquisitions, it’s deja vu all over again.

The U.S. Department of Justice (DOJ) is investigating UnitedHealth Group’s proposed purchase of Change Healthcare, self-described in its Wikipedia entry as “a provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers, and patients in the U.S. healthcare system. The name also refers to a company founded in 2007 which subsequently became part of the current conglomerate.”

One would think that 2-sentence description alone would provide the DOJ just cause for stopping the acquisition, but perhaps the DOJ, like most of the country, doesn’t quite understand the implications if Change were to enfold itself into the UnitedHealth conglomerate. (See this article by NCPA CEO Doug Hoey for one possible explanation why giant corporate mergers are so difficult to stop in the U.S.).

There are many reasons we oppose this acquisition: continued integration means fewer competitors and less choice for end-users of healthcare data services (not that we should be the ones to fight that fight, but still). Consolidation of healthcare service providers into large, single entities leads to less competition and ultimately no reason to compete on price.

But perhaps most disturbingly, Change Healthcare is an independent arbiter of healthcare claims, the outside entity that compares submitted claims against the terms of payer contracts. As such it has access to explosively sensitive data — not just patient data (for some reason not cause enough to stop the acquisition) — but also the “proprietary” and “trade” secret information PBMs and their insurer parents have fought to the death of nearly every type of reform to protect.

Now here comes UnitedHealth — or more accurately UnitedHealth’s Optum Insights (Change Healthcare’s competitor and also its largest customer) — to acquire Change and with it every bit of competitive intelligence. What does that mean for consumers and payers? Who will be the independent entity accountable for the accuracy of claims submitted for payments? And why haven’t CVS and Cigna/Express Scripts opposed the acquisition if their so-called “proprietary” and “trade secret” information will be seen by their competitor?

We could go on, but time is not on our side, and it isn’t on yours or your patients’ either. At the time of publication, we are drafting our letter to the DOJ protesting this merger. We invite you and your patients; your state or independent pharmacy organization; business, chamber, municipality, or other associations to sign our letter or to submit one of your own asking the DOJ to thoroughly investigate — and ultimately block — this acquisition. Enough is enough.

Monique Whitney, PUTT Executive Director

PUTT is a nonprofit organization dedicated to advocating on behalf of independent pharmacy & fighting against PBM anti-competitive business tactics. TruthRx.org

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