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Surprise Settlement In Sutter Health Antitrust Case

Analysis  |  By KFF Health News  
   October 16, 2019

Details have not been made public, and the parties declined to talk to reporters.

This story was first published on Wednesday, October 16, 2019 in Kaiser Health News.

By Jenny Gold

SAN FRANCISCO – Sutter Health has reached a tentative settlement agreement in a closely watched antitrust case brought by self-funded employers, and later joined by the California Attorney General’s Office. The agreement was announced in the San Francisco Superior Court Wednesday morning, just before opening arguments were expected to begin.

Details have not been made public, and the parties declined to talk to reporters.  Superior Court Judge Anne-Christine Massullo told the jury that details will likely be made public during the approval hearings in February or March.

There were audible cheers from the jury following the announcement that the trial, which was expected to last for three months, would not continue.

Related: Hospital Giant Sutter Health Faces Legal Reckoning Over Medical Pricing

Related: Sutter Health, Affiliates to Pay Back $30M for Medicare Advantage Overpayments

Sutter stood accused of violating California’s antitrust laws by using its market power to illegally drive up prices. Health care costs in Northern California, where Sutter is dominant, are 20% to 30% higher than in Southern California, even after adjusting for cost of living, according to a 2018 study from the Nicholas C. Petris Center at the University of California-Berkeley cited in the complaint.

The case was a massive undertaking, representing years of work and millions of pages of documents, California Attorney General Xavier Becerra said before the trial. Sutter was expected to face damages of up to $2.7 billion. Sutter Health consistently denied the allegations and argued that it used its market power to improve care for patients and expand access to people in rural areas. The nonprofit chain has 24 hospitals, 34 surgery centers and 5,500 physicians across Northern California, and had $13 billion in operating revenue in 2018.

Related: DOJ Takes Aim at Sutter Health, Claiming Inflated MA Risk Scores

Related: Hospitals Claim Their Mergers Reduce Costs, Disputing Other Studies

The case was expected to have nationwide implications on how hospital systems negotiate prices with insurers. It is not yet clear what effect, if any, a settlement agreement would have on Sutter’s tactics or those of other large systems.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Jenny Gold: jgold@kff.org@JennyAGold

KFF Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.


KEY TAKEAWAYS

Sutter stood accused of violating California’s antitrust laws by using its market power to illegally drive up prices.

Cheers erupted from the jury following the announcement that the trial, which was expected to last for three months, would not continue.

Healthcare costs in Northern California, where Sutter is dominant, are 20% to 30% higher than in Southern California.


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