Terre Haute, Ind.-based Union Health has withdrawn its certificate of public advantage agreement for its proposed merger with Terre Haute Regional Hospital, a 278-bed facility operated by Nashville, Tenn.-based HCA Healthcare.
Union Health pulled its COPA application — initially filed in September 2023 — just nine days before the state was set to make a final decision on the transaction.
The health system plans to resubmit a COPA application for the acquisition of Terre Haute Regional, according to local news outlet WTHI 10. The review process of a COPA document takes the state 120 days to complete.
The move comes amid community backlash and federal scrutiny around the potential antitrust concerns that the transaction could have created in the area.
The Federal Trade Commission in September advised the Indiana Department of Health against approving the deal, arguing that it would "likely impose higher costs and could lead to worse healthcare outcomes for Indiana patients, as well as lower wage growth for hospital workers."
The FTC told Indiana regulators COPAs are "unwieldy," "difficult to manage" and "have failed to protect local communities from the harmful effects of anticompetitive hospital mergers."
"Recognizing the COPA process is a very complex, innovative approach to improving access and quality health care for area residents, we believe it is best to withdraw the current application to allow time for Union Health and Terre Haute Regional to continue to work with IDOH, to ensure the benefits, including improved access, quality, prevention and early intervention, are outlined in the new application," Union Health said in a statement shared with Becker's.
The FTC said is pleased with Union Health's COPA withdrawal and the agency will continue to closely monitor developments with this proposed merger.
"This is good news for patients and healthcare workers in Indiana's Wabash Valley region, because this proposed merger would raise healthcare costs, reduce access to quality care, and depress wages for hospital workers," The FTC said in a Nov. 26 statement. "We are heartened that the Indiana Department of Health appears to be taking seriously the many concerns expressed by the public about this merger, and hope they will ultimately deny the COPA."
Union Health is an independent, nonprofit system with more than 3,000 employees, according to its website. It includes Union Hospital, a 285 bed acute care facility, and Union Hospital (Ind.) Clinton, a 25 bed critical access facility.