DELAWARE — The Ohio Nurses Association is asking the U.S. Department of Justice to review OhioHealth’s decision to close Grady Memorial Hospital’s inpatient maternity unit, arguing the closure is part of a broader pattern of reduced access to healthcare in central Ohio.
The request comes after the U.S. Department of Justice’s Antitrust Division and the State of Ohio announced a proposed settlement in June resolving a federal antitrust lawsuit against OhioHealth.
The lawsuit alleged the healthcare system used its market power to require commercial insurers to accept contract provisions that reduced competition and increased healthcare costs for Ohio patients.
Put simply, federal officials allege OhioHealth used its size and influence to make it harder for insurance companies to offer lower-cost health plans, resulting in higher healthcare costs for consumers.
The proposed settlement would prohibit those contract provisions, require compliance reporting and appoint an independent monitor for five years if approved by the court.
“The proposed settlement would make healthcare more affordable by forbidding OhioHealth from imposing terms in its contracts with commercial health insurers that deter budget-conscious healthcare plans that would lower costs for Ohio consumers and employers,” the Justice Department said in their announcement.
The Ohio Nurses Association (ONA), which does not represent OhioHealth employees but regularly advocates on statewide healthcare policy issues, argues the federal case should not stop with insurance contracting.
In a letter submitted during the settlement’s public comment period, the union contends OhioHealth’s market power has also contributed to the loss of essential healthcare services, pointing to the closure of Grady’s maternity unit as an example of what it calls healthcare “deserts” left in the wake of hospital acquisitions and service reductions.
“OhioHealth has grown in size and power to the extent that it is able to manipulate the healthcare market in ways that greatly harm central Ohioans’ access to healthcare services,” said ONA President Rick Lucas, RN.
Using Grady as an example
In its letter, ONA points to OhioHealth’s decision to eliminate inpatient maternity services at Grady Memorial Hospital as an example of a broader pattern of healthcare consolidation followed by reductions in local services.
The organization argues that healthcare systems often justify acquisitions and affiliations by promising stronger local healthcare, improved access and long-term investment.
But after healthcare systems become more consolidated, the letter says, communities can be left with fewer healthcare choices as essential services are centralized or eliminated.
The letter argues those decisions affect not only where patients receive care, but whether communities continue to have access to essential services at all.
“Communities lose independent healthcare options. Market concentration increases. Essential services are centralized or eliminated. Patients travel farther. Healthcare workers leave their communities. Local hospitals become shells of what they once promised to be,” the letter states.
The ONA also notes that Delaware County is one of Ohio’s fastest-growing counties and argues families will now have to travel farther for labor and delivery care following Grady’s closure.
Lucas said longer travel times can have real consequences for patients.
“It’s lives. It’s complications,” Lucas previously told Delaware Source. “Even if we’re not talking about death, we’re talking about complications that have long-term impact.”
OhioHealth has said the decision to close Grady’s maternity unit followed a review of the program and reflected declining obstetric volumes both nationally and locally. The health system said fewer than 10% of babies born within the OhioHealth system to Delaware County families during the previous fiscal year were delivered at Grady.
It has also said many families were already choosing Dublin Methodist Hospital and Riverside Methodist Hospital, which provide around-the-clock obstetric coverage and higher levels of newborn care.
What ONA wants investigated
Lucas argues the Justice Department should use the Grady closure as an opportunity to examine a broader question than the one raised in its antitrust lawsuit.
“While that case focused on commercial contracting practices, we believe a larger question deserves examination: How is OhioHealth’s growing market power affecting access to essential healthcare services for the communities it serves?” Lucas wrote.
The Ohio Nurses Association asked the Justice Department to examine whether:
- hospital consolidation has reduced meaningful healthcare competition;
- commitments made during hospital acquisitions or affiliations have been fulfilled;
- market dominance allows healthcare systems to eliminate services that might otherwise remain available in a competitive market; and
- communities ultimately experience reduced access to care despite increased market concentration.
“Competition policy exists to protect the public,” Lucas wrote. “In healthcare, protecting competition must also mean protecting access.”
The Justice Department is accepting public comments on the proposed settlement before a federal judge determines whether it is in the public interest and should be approved.
