Week Ten Takeaways

Date: January 20, 2025

Happy New Year!

A new executive leader at OHSU has come and gone since our last message, where we described the impact that leadership instability and employee lack of confidence could have on the acquisition of Legacy Health. Less than four weeks after arrival, the new interim CEO of OHSU Health was replaced with another leader – making this the third interim in the last year for arguably the most important role of this transaction. Legacy will be adding six hospitals to OHSU’s two, and the head of the future combined health system is an interim hired by an interim. The lack of leadership continuity and permanence has made the environment unpredictable.  

The last time OHSU hurriedly replaced an executive leader (their past president), Governor Kotek issued a public statement to prevent an overnight decision that would have circumvented due process. The business community also played an influential role before OHSU finally announced a national search for their next president. For an organization that emphasizes its status as a public corporation, their leadership decisions play out like no one is watching. If the highest levels of government and business are compelled to intervene in standard hiring processes, it raises concerns about OHSU’s ability to effectively lead the largest transaction in Oregon’s history.

When political leaders and those in power make decisions on behalf of others behind the scenes, it is all the more important for affected communities and individuals to speak up. We hope the Oregon Health Authority evaluates all concerns shared by public comment in accordance with Health Care Market Oversight law, despite their close relationship with OHSU. Brown University and the American Economic Liberties Project (AELP) recently took opposition to the transaction in public comment, outlining discrepancies between statements in the HCMO filing and the criteria required for transaction approval and success. Their argument was thoroughly researched and presented. 

Brown University is a major academic institution that weighs in on regulatory matters when concerning its own interests or the broader academic landscape. The AELP is an advocacy organization that engages in transactions that they believe could harm consumers or reduce competition. There are notable instances where the AELP has contributed to federal oversight of mergers and acquisitions in health care. Its campaigns and subsequent actions by the Department of Justice and Federal Trade Commission have been effective in raising awareness and calling for more aggressive antitrust enforcement: 

  • The acquisition of Change Healthcare by UnitedHealth, where the DOJ filed a lawsuit to block the merger and prevent decreased competition and innovation 

  • The Anthem-Cigna and Aetna-Humana merger failures, where AELP contributed to a broader public and legal push

  • The merger between Advocate Aurora Health and Atrium Health, where the FTC imposed conditions and required divestitures to preserve competition in some areas

The combination of OHSU and Legacy Health may be the first health care transaction in which Brown University and AELP have collaborated to submit public comment. If the decisions of this transaction are above reproach and well managed, the input of antitrust advocacy groups should be welcomed — particularly when the interest is to protect consumers or patients.

Please reach out to elected officials like Senators Ron Wyden and Jeff Merkley to share your thoughts on the transaction. We also encourage you to attend town halls in your local communities. More information is available on our Get Involved page.

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