McLaren St. Luke’s has filed an antitrust lawsuit in an attempt to stop ProMedica Health System from terminating the hospital and its physicians from the commercial and Medicare Advantage health plans offered by ProMedica’s Paramount subsidiaries, effective January 1, 2021.
If allowed to stand, ProMedica’s termination will prevent thousands of individuals and families covered by these health plans from seeing their own doctor or receiving non-emergency care at any McLaren St. Luke’s or WellCare Physicians Group location.
The suit, which was filed in the United States District Court for the Northern District of Ohio, alleges that ProMedica engaged in a pattern of monopolistic and anticompetitive behavior designed to maintain and increase its dominant market position by limiting patient choice and causing harm to St. Luke’s and its affiliated physicians.
According to the complaint, ProMedica’s recent actions were triggered by McLaren Health Care Corporation’s recent acquisition of St. Luke’s, which will make the Maumee hospital a more robust competitor by funding significant investments and introducing health care services not currently available in Lucas County.
With 91,000 members in its Paramount health plans, the suit alleges that ProMedica has an estimated 50 percent of overall hospital market share in the area and as much as 70 percent in certain service lines. The suit also alleges that ProMedica has amassed significant control over the Toledo-area hospital market and has the power to raise prices and stifle competition.
In addition to providing notice of its intent to drop St. Luke’s from these health plan networks the day after McLaren’s acquisition was complete, the complaint details ProMedica’s termination of eight separate contracts to provide services on the St. Luke’s campus and says it pressured other ProMedica physicians to stop practicing at the hospital. The suit contends ProMedica’s actions are contrary to its own business interests and make sense only as an effort to harm St. Luke’s and maintain ProMedica’s dominance.
“This challenge comes as McLaren St. Luke’s prepares to make significant investments that will allow our hospital to better serve the community with a broader range of services, which ultimately creates increased competition for ProMedica,” said Jennifer Montgomery, president and CEO of McLaren St. Luke’s. “By terminating McLaren St. Luke’s in-network provider status, ProMedica is penalizing their own members by limiting choice and causing significant damage to our hospital.”
The court filing outlines a 13-year campaign to prevent or suppress competition from St. Luke’s. According to the complaint, ProMedica has also attempted to neutralize competition from The University of Toledo Medical Center by engaging in an affiliation agreement, which has shifted large numbers of the UTMC faculty to ProMedica.
“Our community is fortunate to have access to several high-quality hospitals and many skilled health care providers – allowing patients a choice of where they can receive care,” said Maumee Mayor Rich Carr. “Restricting that choice will negatively impact thousands of individuals and families – disrupting the trusting relationship they have built with their doctors and undermining competition that drives innovation and quality improvement. Now more than ever, our community benefits from having a strong and thriving local hospital.”
“Our hospital has long been known as a high-quality, low-cost provider in the market,” said McLaren St. Luke’s board chairman Bill Carroll. “Restricting patients’ access to receiving care locally and preventing the introduction of important new services harms everyone – including Paramount’s own members. With more than $100 million in planned investments to McLaren St. Luke’s facilities and services at stake, the community will pay a significant price if ProMedica’s strong-arm tactics are allowed to stand.”
McLaren St. Luke’s has launched a website to keep the community informed and provide patients with information on the more than 30 health plans that continue to offer in-network access to the hospital and its WellCare Physicians Group. For more information, please visit StandWithMcLarenStLukes.org.