OhioHealth agrees to settlement ending contract practices accused of limiting healthcare competition

OhioHealth has agreed to a proposed settlement after state and federal officials accused the healthcare system of using its market power to restrict competition and make it more difficult for patients to find lower-cost healthcare options.

The proposed settlement, announced Wednesday by Ohio Attorney General Andy Wilson and the U.S. Department of Justice, resolves allegations that OhioHealth required insurers to accept contract terms that limited competition in central Ohio.

The agreement comes months after state and federal officials filed an antitrust lawsuit accusing OhioHealth of using its size and influence to prevent insurers from steering patients toward lower-cost providers and sharing information that could help consumers compare healthcare options.

“Healthcare works best when patients have clear choices and honest information,” Wilson said in a statement. “This settlement promotes fairness and creates a better system for everyone.”

According to the lawsuit, OhioHealth used contract provisions that prevented insurers from sharing information with patients about the cost or availability of alternative providers, discouraged insurers from directing patients toward lower-cost healthcare options, and limited the development of insurance plans designed to increase competition.

State and federal officials argued those restrictions reduced competition among healthcare providers and made it more difficult for employers, families, and patients to access lower-cost care.

Regulators argued the contract provisions ultimately reduced consumer choice by limiting insurers’ ability to steer patients toward less expensive healthcare options.

The lawsuit was originally filed in February by the U.S. Department of Justice and former Ohio Attorney General Dave Yost.

“When competition is blocked, consumers end up being the biggest losers,” Yost said when announcing the lawsuit.

According to court filings, OhioHealth owns or manages 16 hospitals and outpatient facilities throughout Ohio, giving the system substantial influence in the central Ohio healthcare market.

Under the proposed settlement, OhioHealth would be prohibited from enforcing contract provisions that limit insurers from sharing price, quality, or other information with patients that could influence where they seek care. The agreement would also bar OhioHealth from restricting insurers from encouraging patients to use lower-cost providers or from obtaining future contract provisions that penalize insurers for creating healthcare plans designed to steer patients toward more affordable options.

As part of the settlement, OhioHealth must notify insurers that any existing contract provisions covered by the agreement are no longer enforceable and implement compliance measures designed to prevent future violations. The proposed settlement also calls for an independent monitor to oversee compliance.

The case centered on contract provisions that regulators said discouraged insurers from providing price transparency tools or directing patients to lower-cost providers offering comparable care. Federal and state officials argued those restrictions limited consumer choice and reduced competitive pressure within the healthcare marketplace.

The proposed settlement was filed in the U.S. District Court for the Southern District of Ohio and remains subject to court approval.