Epic Faces Antitrust Lawsuit from Particle Health Over Payer Platform Control

According to Fierce Pharma, the lawsuit alleges that Epic is using its dominance in the EHR market to expand its control into the payer platform space, potentially undermining new competitors like Particle Health. Epic has yet to comment on the case.

Particle Health, a venture-backed health data platform, provides access to medical records for over 300 million patients, acting as a bridge between digital health companies and healthcare providers. The startup claims that Epic has purposefully blocked the exchange of patient information, which is essential for care coordination between payers and providers.

“Epic Systems controls the medical information of nearly every American, meaning one private company has unchecked power over our healthcare,” said Particle Health CEO Jason Prestinario in a statement. He accused Epic of using its market dominance to disrupt competition in new areas of healthcare data, particularly platforms aimed at improving payer-provider collaboration.

Per Fierce Pharma, the suit also seeks relief under the Sherman Act, a U.S. antitrust law, calling for an end to what it describes as Epic’s anticompetitive conduct. Particle Health further claims that Epic’s actions could limit access to health data for payers, potentially impacting patient care.

This lawsuit follows a series of disputes between the two companies. In April, Epic cut off data access to some of Particle Health’s customers, citing concerns about potential privacy risks related to patient data, according to a notice obtained by Fierce Healthcare. Particle Health founder Troy Bannister later confirmed that Epic had stopped responding to certain medical record requests, escalating tensions between the two health tech companies.

Particle Health argues that Epic’s refusal to share data isn’t just a business issue—it’s also a matter of patient rights. “Doctors need the full medical records of their patients, and this lawsuit represents more than just a business dispute. It’s about medical ethics and protecting patients’ rights to their health data,” executives from the company emphasized in a press release.

With a significant 36% share of the hospital sector, Epic holds a dominant position in the health IT industry. According to the lawsuit, Epic controls the health data of up to 94% of Americans, giving the company enormous leverage over the flow of medical information.

For Particle Health, this case highlights broader concerns about the monopolization of health data, an issue that has been brewing for some time. As the payer platform market continues to grow, startups like Particle, Health Gorilla, and Zus Health are striving to create a more interconnected health ecosystem. These companies serve as intermediaries, making it easier for digital health organizations to access critical data, similar to how Stripe simplifies payment processes in the financial industry.

Source: Fierce Pharma