Ohio Attorney General Signs Off on General Catalyst-Summa Deal—With Strings Attached

With state conditions in place to preserve services and community benefits, the deal marks a new era for one of Ohio’s largest health systems.

Ohio Attorney General Dave Yost has approved General Catalyst’s acquisition of Summa Health, paving the way for the venture capital firm’s expansion into hospital ownership—if the deal meets 10 conditions.

Yost’s review focused on ensuring the transaction met legal requirements for a conversion from a nonprofit health system to a for-profit organization. As part of the approval, General Catalyst and Summa must agree to a set of conditions intended to preserve access to care and protect community interests.

Those conditions are headlined by the purchase price needing to increase by $15 million in cash and another $15 million in equity required for the surviving nonprofit foundation, according to a letter sent to General Catalyst and Summa Health.

General Catalyst’s Health Assurance Transformation Corporation (HATCo) subsidiary signed a definitive agreement in November to acquire the Ohio-based hospital operator for $485 million, allowing Summa to pay off its $850 million in existing debt.

In addition to setting aside funds for the nonprofit foundation, Yost wants the foundation to agree not to sell its $15 million equity interest for three years after closing the deal. Further, the charitable purpose of the foundation receiving the funds must be consistent with Summa’s original charitable purpose and most of the foundation’s board members will have no affiliation with Summa.

Other conditions set by Yost include that the attorney general will retain enforcement authority over HATCo’s obligations to Summa for 10 years, HATCo must submit an annual compliance report to the attorney general for the same period, and it must notify the attorney general of any transactions that could raise antitrust concerns during that time.

“My role in this process is to protect Ohio’s charities,” Yost said in the news release. “After a comprehensive review by the Charitable Law Section of my office, we’re confident that the agreement includes enforceable commitments that will secure Summa’s nonprofit mission, protect patient care, and ensure continued investment in the greater Akron community.

“With proper safeguards in place, this has the potential to strengthen health care in northeastern Ohio for years to come.”

A Summa spokesperson said in a statement that the health system and General Catalyst will work to satisfy Yost’s conditions.

“This is a significant milestone and follows the recent approval we received from the Ohio Department of Insurance,” the spokesperson said. “With these two crucial regulatory approvals now received, we look forward to continuing to focus on completing all of the remaining details necessary to finalize the transaction, including the legal work required to meet the conditions developed by the attorney general’s office and the receipt of all other regulatory approvals.”

The deal has been closely monitored across the industry. While private equity involvement in hospitals has drawn scrutiny for aggressive cost-cutting and staffing decisions, General Catalyst is aiming to establish a model that combines mission-aligned goals with capital-driven transformation.

Still, critics argue that any for-profit shift comes with inherent risks, particularly in underserved communities. A coalition called Summa Is Not for Sale has pushed back against the deal, claiming it will negatively impact the health system’s patients and workers.

While the coalition continues to believe that the sale price for Summa is well short of its true value, member Jeff Barge said in a statement that the attorney general’s conditions improve upon the deal’s transparency and community benefits.