A healthcare industry ripe for consolidation is coming under increased scrutiny by the Biden administration, which has already blocked four hospital mergers. In an interview with Kaiser Health News, Mark Seidman, assistant director in the Federal Trade Commission’s Bureau of Competition, said the administration is looking closely at mergers because it wants to protect patient access to care, slow price increases, and prevent employee layoffs and unfair labor practices.

“Hospitals are large employers in whatever geography they exist in,” Seidman told KHN. “A merger between hospitals that are relatively close can have an impact on the labor market. That’s been less of a feature up to now in litigated antitrust cases, but it’s top of mind as a policy matter.” 

The home care and hospice industries have been at the center of robust merger and acquisition activity for the past two years. Some of the largest deals have been inked by firms outside of the sector, such as UnitedHealth’s acquisition of LHC Group and Humana’s acquisition of Kindred at Home, now known as CenterWell Home Health. Seidman said those mergers are raising less scrutiny from the FTC than so-called vertical mergers, which involve mergers within the same industry.

Still, the administration is examining possible antitrust violations in home care. It also is keeping a close eye on the home care industry in other ways. In recent months, both the Department of Justice and Department of Labor have been pursuing agencies for fraud or violations of the Fair Labor Standards Act. In a recent case against a Dayton, OH, home health firm that misclassified workers and failed to pay them overtime, the Department of Labor said violations, such as that, have become common in the home care industry.

“The U.S. Department of Labor will protect the rights of workers who commit themselves to the care of others and ensure they are paid all their legally earned wages so they, in turn, can take care of themselves and their families,”  DOL’s Wage and Hour Division District Director Matthew Utley said in a statement.