Dana Gibbon was 18 months pregnant with her first child when her OB-GYN told her at an interview that she wouldn’t be her doctor again.
In Corvallis, a rural Oregonian village of 60 000, OB-GYN services were closing down at the office. The dentist said all of the Corvallis Clinic’s OB-GYNs were resigning.
In a subsequent letter to clients, the doctor stated,” We have appreciated the opportunity to participate in your care and apologize for any inconvenience this may reason.”
The closing of the Corvallis OB-GYN exercise came two years after a company of UnitedHealth Group, the country’s largest health insurance company, bought the doctor. Optum Oregon, a subsidiary of the company, cited a nationwide shortage of physicians, which made it difficult to substitute them and put added strain on those who stayed.
Gibbon feverishly looked for another physician. Friends of the other obstetric methods urged them, but both had stopped. Gibbon settled on a small medical close to home with four devoted pregnancy beds — all of which were full when she was expected to deliver in April, delaying her induction three times. Her happy baby boy was finally delivered on April 29 via a caesarean section, a procedure she had hoped to avoid.
” It’s difficult not to know if things may have gone different if there had been more labor and delivery beds in the area”, she said.
Despite a special Oregon laws intended to stop it, Corvallis sufferers like Gibbon faced this disturbance.
In 2021, the state became the first in the country to offer its state health department the large power to block acquisitions and mergers of hospitals, hospices and health practices, an effort to counter the combination that research shows is cutting competition and driving up costs nationwide.
According to lawmakers, Oregon’s novel oversight authority may prevent multibillion dollar deals from lowering treatment and escalating costs. State authorities got the power to accept transactions or to increase conditions and tax fines if companies disregarded them. The legislation was praised as a unit for the nation.
Five years later, Oregon has never fully blocked a single purchase or issued any charges. Some people who supported the legislation claim it has not been nearly as effective as hoped, despite the fact that the new monitoring is credited with leading to the removal of two well-known trades: the merger of two Portland-area medical devices and the acquisition of a nonprofit that provides Medicaid benefits to half a million Oregonians.
Dr. John Santa, a retired physician and former member of the Oregon Health Policy Board, which oversees the state agency responsible for implementing the new law, said his interactions with the program were” so disappointing and fell so short of what I expected. I never imagined that it would perform as poorly as it does.
Of the nine healthcare deals for which regulators have done follow-up reviews, at least three had outcomes the law was meant to forestall, ProPublica’s examination of state records found.
LHC Group, a home health provider, was purchased by UnitedHealth Group for$ 5.4 billion in 2023. It shuttered a rural hospice agency in Central Oregon two months later, funneling staff and patients to a location nearly 30 miles away. The state later stated that the decision raised concerns about potential access reductions. A UnitedHealth spokesperson said the closure did not reduce services because patients and staff were reassigned and it continued to serve the same areas.
After Amazon purchased One Medical for$ 3.9 billion that same year, it closed the company’s downtown Portland practice and reduced operating costs by$ 100 million across the country. It saw a drop in Oregon patient satisfaction scores, as measured by an outside group, a state review noted. One Medical’s deal was not made public by Amazon.
Oregon in 2022 approved the acquisition of a hospice provider by a private equity firm, Clayton, Dubilier & Rice. The company stated to the regulators that it would not alter its workforce or locations. Oregon took the company at its word — then watched it close a Salem hospice after the deal closed.
The state noted the closure and made reference to” some changes” in Oregon staffing in a follow-up report, but it would not say whether this included adding or reducing employees, claiming that the companies involved had designated the information as confidential.
A spokesperson for Clayton, Dubilier & Rice didn’t address the closure but said in a statement that its hospice acquisition was “premised on the company delivering high-quality care”. According to the spokesperson, the company’s hospice providers in 2024 and 2025 received higher ratings than any other national provider in standardized consumer surveys, and the company’s patient ratio increased by 5.5 % over the course of its ownership ownership history.
Clare Pierce-Wrobel, the health policy and analytics director for Oregon’s health department, the Oregon Health Authority, acknowledged that the state held some mergers to a lower standard while the program was just getting started.
” I believe there might have been a different outcome” she said if those notices had been received when the program was fully operational.
Dr. Nicole Kruppa had a thriving OB-GYN practice at the Corvallis Clinic before it was taken over by Optum. She claimed to have left after the sale because her workload became insufficient. She said burnout became so intense that she worried she would either make a medical mistake or get in a late-night car accident while driving to deliver a baby.
Optum failed to fill vacancies when medical staff took planned leave, she claimed. Annual medical exams had to be postponed so the remaining OB-GYN staff could attend to emergencies, she said.
According to Kruppa,” I felt like I could no longer give my patients the care they deserved.”
A UnitedHealth spokesperson, Tyler Mason, said Optum helped keep the Corvallis Clinic’s doors open. Our goals have been stabilizing practices, expanding access, and strengthening clinical services to preserve local care, maintain critical services, and allow patients to continue receiving the care they depend on close to home, Mason said.
In order to ensure that those transactions made sense, Oregon lawmakers created the merger and acquisition oversight program in 2021. They claimed they were only trying to stop every healthcare deal.
Consolidation in the healthcare industry is rife. According to research, 50 % of the country’s doctors were employed by a hospital system in 2024, up from less than 30 % in 2012. As competition narrows, studies show, prices can increase, the quality of care can decline and treatment can be harder to access, especially in rural areas.
Five states last year approved laws expanding their authority over the consolidation of healthcare, akin to Oregon’s. One of them, Maine, adopted a bill this April that requires state review and approval of the sale of healthcare facilities when private equity firms are involved. In addition, New Mexico passed a bill akin to Oregon’s in 2024.
Pierce-Wrobel, the health authority official, said Oregon is clearly a national leader. People in Oregon are fortunate to have this kind of program, she said.
” The ability to actually see how these decisions are made and how it’s actually impacting your healthcare before it happens is novel and addresses a real, pressing issue”, she said,” which is affordability in healthcare, which impacts all of us”.
Oregon has conditions on 15 of the 65 transactions it has evaluated, but it hasn’t blocked any of them. It has required doctors to continue serving patients covered by Medicare, the federal insurance program for seniors and the disabled. It has mandated continued access to reproductive and gender-affirming healthcare and required thorough annual reporting.
The state also has required a deeper six-month review in seven cases, three of which are still underway. The other four agreements were withdrawn, most notably the proposed mergers of CareOregon, which administers Medicaid plans for more than 500, 000 low-income people, and Legacy Health, which are two significant Portland-area hospital systems. Facing a public outcry, the healthcare organizations canceled their deals.
Dr. Jane Zhu, a primary care physician and associate professor of medicine at Oregon Health & Science University who studies healthcare access, said programs like Oregon’s add urgently needed transparency to medical decision-making.
But they “don’t necessarily change the equation” when it comes to the trend toward consolidation, she said in an email. The reality is that “regulators can approve the merger and prices go up and consolidation worsen, or they can block a merger and perhaps there is an immediate effect on the clinic’s solvency or sustainability,” especially in rural areas.
According to Larry Kirsch, a health economist, one problem is that Oregon regulators have typically chosen the fastest option for reviewing acquisitions allowed under the law, 30 days. That’s not enough time, according to Kirsch, to adequately study what a transaction will affect medical care.
” I was gobsmacked by how superficial, how inconclusive, how nonrobust the investigation was”, said Kirsch, who has examined dozens of Oregon’s oversight reviews. You’d have to say that some of them were so outrageous that their eyes were completely closed.
Pierce-Wrobel said Oregon welcomes “public input to inform our review of individual transactions — as well as opportunities to improve how we implement this new program — in order to advance Oregon’s goals of health equity, lower costs, increased access and better care. Nonetheless, the program must adhere to its statutory requirements.
Nowhere are the limitations of the review process more evident than in the city of Corvallis, home to both Oregon State University and the Corvallis Clinic, which had operated as an independent, doctor-owned practice since 1947.
Ironically, one of the clinic’s executives, on behalf of the Oregon Independent Medical Coalition, a lobbying group for private practices, testified against the law in 2021 on behalf of the law. Scott Shollenbarger said that the group’s members were committed to remaining independent.
We firmly believe that healthcare is best provided in an independent business model that is owned and run by the business’s owners, who are also in charge of providing medical services to our respective populations, he wrote at the time.
But by 2023, the clinic’s finances had deteriorated and it struck a deal to be acquired by Optum Oregon. Kruppa, the former Corvallis shareholder and former employee, claimed the clinic was losing up to$ 1 million per month at the time.
With hundreds writing to the state to oppose the acquisition, regulators developed conditions to protect patients. They created requirements that the new owner must follow in order to maintain their current clinical programs and accept an independent monitor to ensure compliance.
As Oregon reviewed the deal, the clinic’s finances worsened, Kruppa told ProPublica. She claimed that doctors went without pay in the month leading up to the deal in order to keep the clinic’s doors open until the deal was approved.
Then a Russian-linked ransomware hack targeted Change Healthcare, a UnitedHealth subsidiary that provides payment and claims processing to hospitals and doctors ‘ offices. The Corvallis Clinic was one of the country’s medical centers that were affected by the attack. Kruppa said the clinic was preparing for a bankruptcy filing, worried that the hack would further delay closing the deal.
Following the hack, UnitedHealth announced that it had extended$ 9 billion in no-interest loans to hospitals and medical establishments all over the country. In testimony to the U. S. Senate Finance Committee, then-CEO Andrew Witty said:” I want this committee and the American public to know that the people of UnitedHealth Group will not rest — I will not rest — until we fix this”.
The clinic requested an urgent exemption from the sale’s ongoing review two weeks after the hack and told the state that it was in danger of failing. Clinic attorneys assured the state the transaction was “expected to maintain essential services at or above current levels”. They claimed that by making a more stable operation, the sale would also “improve the Clinic’s ability to attract and retain top-notch candidates for open positions.”
Oregon’s oversight program agreed to dispense with its review — the only exemption it has granted — in just five days. The state removed the previous guardrails that it had suggested.
Pierce-Wrobel said the state cannot apply conditions to emergency requests that meet exemption criteria specified in the statute, nor can it review the deals afterward to measure their impacts.
” I understand and hear the criticism, but we are accountable for implementing the law that established this program, and that is what was done,” she said.
A UnitedHealth spokesperson said the company extended a zero-interest loan to the Corvallis Clinic within three weeks of the hack.
Prior to the hack, the practice was “facing serious operational and financial challenges that put patient access at risk,” according to the spokesperson. Since the purchase, “we’ve been working to stabilize practices, recruit clinicians, expand services and improve systems to help ensure patients continue to get the care they need”.
Soon after the sale, the changes at The Corvallis Clinic became clear.
ProPublica spoke to more than 10 current or former patients. After the practice was sold, they described lengthy waits for appointments, delays in procedures, and constant flow of doctors leaving.
One woman said her scheduled pap smear at the Corvallis Clinic was delayed more than six months.
Another claimed that despite the fact that she is supposed to receive frequent cancer screenings because she lost a doctor she trusted so firmly to handle her history of trauma.
Rebecca Geier, 67, said she has lost four doctors at the clinic in the last year.
She told ProPublica in an email that it “disrupted my continued care with these doctors” and that it wasn’t just an inconvenience. ” The dreaded letters from Optum informing me that my doctor had left or was soon leaving the clinic just kept coming, one after another”.
In March 2025, three Mid-Valley Gastroenterology doctors wrote to state regulators to inform them that two of the Corvallis Clinic’s gastroenterologists had left a pool of area physicians who were on-call for emergencies at a significant regional hospital system. They said Optum made the specialists opt out to save money.
Optum “prioritized corporate profit and physician convenience over the well-being of both the patients they treat and the other medical professionals with whom they collaborate,” the doctors wrote.
Mason, the UnitedHealth spokesperson, said Optum did not interfere with or direct the physicians ‘ decisions. According to Mason,” Physicians make their own decisions about participating in on-call coverage based on what they can reasonably manage while caring for their patients.”
If Oregon hadn’t exempted the transaction from its oversight, it’s the type of impact that would have faced regulatory scrutiny during a follow-up review.
A public forum about the deal was held in front of the state, where witnesses heard what had transpired. But regulators said they couldn’t investigate any further.
The article A Special Oregon Law Allows It to Block Healthcare Deals appeared first. In Five Years, the State Hasn’t Done So Once. first appeared on ProPublica.
