Senator Warren asks regulators to watch for ‘serial surges’ in health care

One of the health policy topics that is gaining more and more attention in Washington may soon be “serial roll-ups” supported by private equity firms.

Sen. Elizabeth Warren, D-Mass., expressed this concern in a letter she recently sent to three Biden administration officials tracking health care competition.

A “private equity roll-up” is a move by an investment firm to use many small acquisitions to create large companies. Warren states in her letter that she believes private equity firms and insurers often use roll-up strategies to gain high levels of market share through deals that are too small to receive much, if any, attention from federal regulatory agencies. antitrust at the Federal Trade Commission. and the US Department of Justice.

“Serial roll-ups have become common in the health care industry and have led to market dominance, which has led to higher prices, especially when private capital is involved,” Warren writes. “It is important that agencies recognize this trend in healthcare acquisitions and take a holistic view of market dominance to prevent harm to competition and patients.”

She sent the letter to FTC Chair Lina Khan, U.S. Secretary of Health and Human Services Xavier Becerra, and Jonathan Kanter, deputy attorney general in the Justice Department’s antitrust division.

Warren, who is a member of the Senate Finance subcommittee on health care, has been active in writing in recent weeks asking regulators to toughen up on health insurers and other entities operating in the health care system.

Dan Francis, a law professor at New York University, may have piqued lawmakers’ interest in serial roll-ups in March 2023 when he spoke about the issue during a U.S. Senate Judiciary subcommittee hearing on antitrust concerns affecting digital markets.

He suggested that serial roll-ups have caused hidden consolidation in the kidney dialysis market and impacted patient access to dialysis.