U.S. Anesthesia Partners (USAP): Anticompetitive Practices

Policymakers and federal enforcement agencies are exploring the potential damaging impact of private equity on healthcare, with a particular focus on anticompetitive practices


Private equity–owned healthcare organizations are facing increased scrutiny from regulatory agencies and Congress. The Federal Trade Commission (FTC), the Department of Justice (DOJ), and the Department of Health and Human Services (HHS) are working together to investigate private equity’s (PE) control of healthcare organizations and the impact on patients. In September, the FTC filed a civil complaint against U.S. Anesthesia Partners, Inc. (USAP), one of the largest anesthesiology providers in America, and its PE firm owners — Welsh, Carson, Anderson, & Stowe — for anticompetitive business practices that resulted in artificially inflating prices and monopolizing the anesthesiology market in Texas. After a recent Washington Post investigation of USAP’s anticompetitive practices in Colorado, U.S. Senators Elizabeth Warren (D-MA) and Richard Blumenthal (D-CT) sent a letter to the company arguing that USAP pressured physicians in Colorado to raise prices by leveraging noncompete agreements against them. The Senators’ concern was that this business practice would result in fewer choices for patients. In their letter, the Senators requested more information on USAP’s acquisition practices, use of noncompete agreements, and profit margins.


On June 29, 2023, The Washington Post released its investigation into USAP’s practices in Colorado. On September 21, 2023, the FTC sued USAP and its PE owners for its expansion practices in Texas. Shortly after, on November 22, 2023, Sen. Warren and Sen. Blumenthal sent USAP their letter, giving the anesthesiology provider until December 11, 2023, to respond to the request for more information. On December 7, 2023, the FTC, DOJ, and HHS announced that they would pursue a more coordinated effort to assess the impact of PE in healthcare.

Key Highlights