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The Curious Case Of Intermountain Healthcare’s Primary Children’s Hospital…Anti-Competitive Behavior Is Alive And Well In Utah

We have written in-depth about the monopolistic practices of Intermountain Healthcare based in Salt Lake City, Utah, where health professionals impacted by anticompetitive behavior say the arrangement harms patient care and a patient’s choice of physician. However, drilling down deeper into the company’s practices with weeks of patient interviews and discussions with physicians in the region, we have uncovered a more serious example at one of their flagship facilities — Primary Children’s Hospital.

As we have laid out in a previous article, Intermountain Healthcare is designated as a non-profit.

The case of Primary Children’s Hospital, located on the campus of  the University of Utah in Salt Lake City, is an interesting one. Decades ago, the land for the hospital was donated to Intermountain Healthcare by the University. In return, Intermountain healthcare allows the University physicians unfettered control of patients at the children’s hospital. According to our investigation, Intermountain Healthcare does not pay the salaries of the university physicians working at the hospital, which amounts to over 90% of the children’s hospital physician staffing. The University needs a quorum of patients for research accreditation. Intermountain Healthcare at Primary Children’s provides these patients. In return, they receive a free physician labor force, while the University physicians group receives all the pediatric patient referrals in the tri-state region.  This purposeful directing of pediatric patient referrals is seldom discussed publicly in Utah due to the anticompetitive behavior.

Over the last decade, most of the independent community physicians privileged at Primary Children’s have been forced out. This leaves a monopoly of University physicians available on the premises for all the referrals. In the lobby of Primary Children’s only University physicians are listed.  Only University physicians are offered lease space for clinics within the hospital. If you call the hospital referral line, only University doctors are suggested.  The University physicians control the Emergency Room, staff the ICUs and nearly every division and specialty offered at Intermountain’s Primary Children’s Hospital.

In short, there is no competition for children’s healthcare in Utah; Intermountain Healthcare controls everything, and receives most of the revenue while paying no taxes or salaries for most staffing at their children’s hospital.  Why do they get to claim not-for-profit status, accept all insurance plans in the tri-state area and then pay no physician salaries?  In addition, why do the pediatric university physicians get to receive all the patient referrals giving the public no choice in their care?  It seems to be not about quality of patient care, but rather about control and dollars at the children’s hospital, the only dedicated pediatric facility serving at least four states. For instance, independent highly qualified, highly specialized physicians are for the most part not allowed to work there.

The question is — why is this facility called an Intermountain Healthcare hospital and not a University of Utah hospital? What is Intermountain Healthcare getting out of all of this? The answer is — a whole lot of money by not having to pay compensation to the physicians working at the hospital…this adds up to tens of millions of dollars annually.

That’s not all.

Most of the neonatal intensive care units (NICU) in the region also are staffed by University of Utah physicians within Intermountain hospitals.  Why? Simply put , Intermountain is then able to control the flow of newborns as they own the majority of the birthing hospitals in Utah.  They then utilize, the University paid staffing in their neonatal units to ship all the pediatric patients to the University physicians at their children’s hospital.  It is not only stifling to well-trained community physician specialists, but does not allow families full complement of choice for their children’s provider, or choice in treating facility, even if it is closer to their homes. 

Why isn’t Intermountain Healthcare telling the community about this arrangement? Why aren’t they talking about it more? If the University owned the hospital and directed patients to go there, this would all be completely normal.  In fact, it is done in many children’s hospitals nationally. However, Intermountain Healthcare owns the facility, makes the monies and yet neither pays for the physicians who work there nor  taxes to support the community….Does this arrangement break any federal laws, regulations?

When told of the situation by one local physician, a mother with a sick child presciently said, “Intermountain Healthcare sees Primary Children’s as an ATM machine only. They are limiting patient choice of physician, making money, and building an empire. No wonder they can sponsor a sports team in Nevada. Some non-profit…”

We emailed Intermountain Healthcare several times and left phone messages regarding this story but received no response.

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