Sutter Health Wins Antitrust Case Amid Stronger Enforcement

Sutter Health, the nonprofit hospital system that dominates the Northern California market, recently won a class action lawsuit brought by individuals and small-group plan sponsors who accused the hospital system of anticompetitive practices, including price gouging. Experts tell AIS Health that the trial shows the difficulty of limiting hospitals’ price-setting power when they consolidate, and that robust antitrust enforcement — the kind that ended a proposed hospital system merger in Rhode Island — is critical to keep prices down.

In the lawsuit, according to a website maintained by the plaintiffs’ council, “plaintiffs claim that Sutter forced upon health plans certain pricing and contractual terms, and those practices and terms violated state and federal antitrust and unfair competition laws. Plaintiffs claim this caused the health plans to pay more than they otherwise would for Sutter’s hospital services, and that this resulted in higher insurance premiums for class members whether or not they used Sutter hospitals.”

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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