HQ Team
August 11, 2023: The UK’s competition regulator, Competition and Markets Authority has provisionally cleared UnitedHealth’s proposed £1.2bn ($1.6 billion) plan to buy EMIS after a probe by an independent panel.
A phase 1 investigation by the regulator had identified concerns that the merger ran the risk of worse outcomes for the publicly-funded National Health Service by reducing competition. The NHS is the second largest single-payer healthcare system in the world after the Brazil’s Sistema Único de Saúde.
“These concerns have been probed in more detail in a phase 2 investigation overseen by an independent panel which has now provisionally found the merger does not raise competition concerns,” the CMA stated.
The independent probe confirmed that EMIS, as the lead supplier to NHS GPs across the UK, holds a particularly strong market position in the supply of electronic patient record systems.
Further evidence-gathering and analysis found the combination of this position with Optum’s activities should not present competition concerns, according to a CMA statement.
Consultation process
The findings are provisional, and the CMA will now consult on its findings and listen to any further views before reaching a final decision.
The regulator welcomed responses from interested parties to its provisional findings by September 1, 2023.
These will be considered ahead of the CMA issuing its final report, which is due by October 5, 2023.
The companies announced the acquisition in 2022, and the deal was referred for a Phase 2 investigation on 31 March 2023.
The NHS is increasingly seeking digital and data-driven solutions to help improve the delivery of healthcare in the UK. EMIS supplies data management systems to the NHS, including the electronic patient record system used by the majority of NHS GPs in the UK.
Optum, part of the US healthcare giant UnitedHealth, currently supplies software used by GPs when prescribing medicines, as well as data analytics and advisory services that the NHS uses to help improve overall healthcare and health service provision.
‘Not to harm competition’
“While the merging businesses do not supply competing services, Optum, and its competitors use the data that EMIS holds and integrate their own software with EMIS’s electronic patient record system to compete in other markets, including the supply of population health management services and medicines optimisation software,” according to the statement.
In the supply of population health management services, the independent panel provisionally found that the merged business would not, in practice, be able to use the EMIS business to harm the competitiveness of rivals. “This is primarily because the NHS would be able to use its oversight role to prevent the merged business from pursuing this kind of strategy.”
In relation to the supply of medicines optimisation software, the independent panel has provisionally found that it would not be commercially beneficial for the merged business to restrict access to EMIS’s electronic patient record system.
A more detailed analysis of the market showed that such a strategy would likely be unprofitable with any possible gains being limited and capable of being reduced through intervention by the NHS.
“Digital technology and data analytics play an increasingly important role in supporting high-quality healthcare in the NHS and so it’s important we investigate this deal thoroughly,” said Kirstin Baker, chair of the independent inquiry panel carrying out the investigation.
Range of evidence
“We want to ensure the NHS continues to benefit from innovation and efficiencies brought about by technology services competing for its business. After carefully considering a broad range of evidence, we have provisionally found that this deal is not expected to harm competition or adversely affect patients.”
Optum is part of UnitedHealth Group Incorporated a large US healthcare insurance, healthcare, and health data analytics business. In the UK, UH operates through Optum Health Solutions (UK) Limited (Optum).
EMIS is an established UK-based healthcare software business that provides a range of IT solutions to the NHS, including a primary care electronic patient record (EPR) system, EMIS Web.
EMIS Web allows GPs to manage appointment bookings, conduct patient consultations, and update, store, and share patient records. EMIS also offers EMIS-X Analytics (EXA), software which allows users to conduct data analysis.
