Case pits newcomer against colossus said to control as much as 80-90% of the market.
Particle Health Inc., a young healthcare data platform provider, has filed an antitrust complaint against Epic Systems Corp., the dominant player in the electronic health records (EHR) space. Particle Health alleges Epic is using its heft to squash competition and block new entrants to the emerging payer platform market. Both companies promote themselves as helping improve healthcare outcomes by facilitating the exchange and analysis of massive troves of patient data between and among health insurers and providers (Particle Health Inc. v. Epic Systems Corporation, No. 1:24-cv-07174, S.D.N.Y.).
According to the suit, filed in the Southern District of New York, Epic Systems has engaged in anticompetitive practices, including:
- Restricting data access: Epic has allegedly restricted Particle Health’s access to patient data, making it difficult for it to compete effectively.
- Imposing unfair terms: Epic has reportedly imposed unfair terms on its customers, discouraging them from using competing platforms.
- Engaging in predatory pricing: Epic may have engaged in predatory pricing, offering its payer platform services at below-cost prices to drive competitors out of business.
In announcing the suit, Particle Health’s CEO said, “Epic has used a multi-tentacled approach to try to squash Particle. Over the past six months, it has cut off access to data for Particle’s customers, lobbed now-discredited complaints, and overwhelmed Particle’s support operations by stoking baseless security concerns. Absent repercussions, Epic will be incentivized to run this playbook again the next time a competitor emerges.”
Citing violations of Sections 1 and 2 of the Sherman Act, the Clayton Antitrust Act, and other statutes, Particle Health seeks injunctive relief and monetary damages. Epic says the claims are “baseless” and promises a vigorous defense.
Particle Health, founded in 2018, tells insurers and providers they can use its services to “fuel innovative solutions with 320+ million patients’ medical records piped from the largest healthcare networks …” The goal, they say, is to help insurers make better decisions and improve patient outcomes. Backed by venture capital, they strive to act as a bridge between healthcare providers and insurers, facilitating the exchange of patient information.
Wisconsin-based Epic Systems controls approximately 81% of the EHR software market, having collected at least one electronic health record for more than 280 million patients in the United States, the complaint states. Epic Systems also sells EHR management systems to healthcare providers. Its share of that market is even larger, with 81-94% of patients in the U.S. having at least one record stored in an Epic-powered EHR. In the market for payer platforms – which facilitate data sharing and communications between health plans and providers – the Epic platform has a greater than 90% market share.
