Oregon House Speaker Dan Rayfield has asked state regulators to extend the public comment period regarding a large health care company’s proposed acquisition of a local clinic in Corvallis, while urging a more comprehensive review of the deal.
In a Jan. 17 letter to the Oregon Health Authority sent under his House District 16 letterhead, the Corvallis Democrat raised concerns about plans by UnitedHealth Group, one of the world’s largest health companies, to purchase The Corvallis Clinic, an independent 11-clinic physician-owned system in the mid-Willamette Valley. If approved, the clinic would become part of UnitedHealth’s Optum Health subsidiary.
The deal is currently undergoing a 30-day review by the health authority’s Health Care Market Oversight office. It takes place against a backdrop of increasing concerns in Oregon and elsewhere about consolidation and the speed with which small practices are being absorbed by large corporations.
“I’ve heard a great deal of apprehension regarding the potential impact of this acquisition on the quality and accessibility of health care services,” Rayfield wrote. “Evidence suggests that investor-owned health care services, such as those owned by UnitedHealth Group, can lead to reduced care quality and access.”
Rayfield is running for attorney general, but did not mention either his candidacy or his status as House Speaker.
State officials issued their notice of the transaction and the public comment period on Dec. 28, during a period in which many people are on vacation. Initially, the notice allowed a public comment until Jan. 18, but the agency has since extended the deadline to Jan. 22
Rayfield wrote that in addition to concerns about the proposed deal, community members are also concerned about “the accessibility of the public comment period.” He asked regulators to extend the public comment period to the full 30 days allowed under state rules.
So far, Health Care Market Oversight staff have posted 114 public comments on its website since notice of the deal was issued, as well as another eight pages that were submitted to the Oregon Health Policy Board. The comments are overwhelmingly opposed to the acquisition.
Lawmakers approved the Health Care Market Oversight program in 2021 to review mergers and acquisitions between large health care companies. Regulators consider how each transaction could affect costs and equity, in addition to quality and access to care.
Health authority spokesperson Erica Heartquist told The Lund Report the merger oversight office usually holds a two-week public comment period for preliminary reviews, Heartquist said.
“This allows time for HCMO staff to consider all comments and include them, as relevant, into analyses, information requests for entities, and findings before issuing a decision,” she said. “Anyone can submit a public comment at any time, but HCMO cannot ensure that comments received outside of the comment period will be considered for a review.”
The program is required to complete preliminary reviews of transactions within 30 days, though the health authority and the companies involved in the transaction can agree to extend the timeline.
UnitedHealth was ranked as the 10th largest company in the world by Fortune magazine and the largest health care company in the U.S. with $324.2 billion in revenue in 2022.
But UnitedHealth has also drawn criticism. An independent pharmacy recently sued the company and one of its subsidiaries for allegedly forcing small pharmacies into financially ruinous contracts. STAT, a health care news outlet, also reported that UnitedHealth allegedly used a secret algorithm to deny care to patients in rehabilitation centers.
The Corvallis Clinic system is the largest multi-specialty outpatient healthcare provider in the mid-Willamette Valley, serving Benton, Linn and Lincoln counties. It employs more than 100 doctors and more than 500 support staff. The clinic’s owners state in application materials that they are seeking to sell because the venture is struggling financially.
Rayfield also requested that the Health Care Market Oversight program allow the health authority to convene a Community Review Board that’ll advise regulators on whether to approve the deal based on its potential impact on services.
“It is imperative that any significant change in our health care landscape not only complies with legal and regulatory standards but also genuinely serves the best interests of Oregonians, particularly in terms of health care access, equity, and cost,” Rayfield wrote.
Heartquist said that after regulators finish their preliminary review of the transaction, they can approve it outright or with conditions. Alternatively, if they have concerns a transaction will adversely affect health care cost, access, quality the agency can launch a longer process called a comprehensive review.
In a comprehensive review, the agency can convene what’s called a community review board to assist in scrutinizing data and documentation related to the deal. Rayfield called for the agency to appoint such a board, saying “I feel the transaction requires this level of review.”
I am appalled that this is even under consideration. Is it not a conflict of interest to have a massive health insurance group buy medical practices? The main concern for United Healthcare would be keeping costs down, thus dictating to the providers how to practice medicine. This is a horrible idea.