The Federal Trade Commission, the Department of Justice’s (DOJ) Antitrust Division, and the U.S. Department of Health and Human Services (HHS) jointly launched a cross-government public inquiry into private-equity and other corporations’ increasing control over health care.

Private equity firms and other corporate owners are increasingly involved in health care system transactions, and, at times, those transactions may lead to a maximizing of profits at the expense of quality care. The cross-government inquiry seeks to understand how certain health care market transactions may increase consolidation and generate profits for firms while threatening patients’ health, workers’ safety, quality of care, and affordable health care for patients and taxpayers.

The agencies issued a Request for Information (RFI) requesting public comment on deals conducted by health systems, private payers, private equity funds, and other alternative asset managers that involve health care providers, facilities, or ancillary products or services. The RFI also requests information on transactions that would not be reported to the Justice Department or FTC for antitrust review under the Hart-Scott-Rodino Antitrust Improvements Act.

“When private equity firms buy out healthcare facilities only to slash staffing and cut quality, patients lose out,” said FTC Chair Lina M. Khan. “Through this inquiry the FTC will continue scrutinizing private equity roll-ups, strip-and-flip tactics, and other financial plays that can enrich executives but leave the American public worse off.”

“Preserving competition in health care markets is a priority for the Department of Justice because of its important impact on the health and well-being of Americans,” said Assistant Attorney General Jonathan Kanter of the Justice Department’s Antitrust Division. “This RFI will enable the agencies to accurately understand the modern market realities of the health care industry and forcefully enforce the law against unlawful deals. Hearing from patients, workers, and market participants will be critical in developing future enforcement and policy efforts relating to consolidation in the health care sector.”

“Increasing competition in health care markets gives people more choices. Competition helps ensure patients have access to high-quality, lower cost care, and that health care workers receive higher pay and work under better conditions. And it saves taxpayers money,” said Health and Human Services Secretary Xavier Becerra. “We need to do more to understand the impact of private equity and corporate dealmaking on our policymaking, regulatory decisions and enforcement actions. The Biden-Harris Administration is committed to improving transparency and competition in health care.”

Research has shown that competition in health care provider and payer markets promotes higher quality, lower cost health care, greater access to care, increased innovation, higher wages, and better benefits for health care workers. Comments submitted in response to the joint RFI will inform the agencies’ enforcement priorities and future action, including potential regulations aimed at promoting and protecting competition in health care markets and ensuring appropriate access to quality, affordable health care items and services.

The agencies’ RFI builds upon the Centers for Medicare & Medicaid Services’ recent RFI on Medicare Advantage and a RFI issued by the FTC and HHS on how pharmaceutical middleman groups may be contributing to drug shortages. The RFI issued today stems from a December 2023 announcement outlining efforts by the DOJ, FTC and HHS to lower health care and drug costs, while promoting competition to benefit patients and health care workers.

In addition to the launch of the RFI, all three agencies will also be participating today in a virtual public workshop that will explore the impact of private equity in health care and will discuss what the federal government is doing to address any harmful effects.

All market participants—including patients, consumer advocates, doctors, nurses, health care providers and administrators, employers, insurers, and more—are invited to share their comments in response to the RFI. The agencies seek comments on a variety of transactions, including those involving dialysis clinics, nursing homes, hospice providers, primary care providers, hospitals, home health agencies, home- and community-based services providers, behavioral health providers, as well as billing and collections services.

The public will have 60 days to submit comments at Regulations.gov, no later than May 6, 2024. Once submitted, comments will be posted to Regulations.gov.