Major labor unions have filed an antitrust complaint requesting that the Department of Justice investigate UPMC for allegedly using its size to wield power over local labor markets in violation of the Sherman Antitrust Act.
The complaint was filed by SEIU Healthcare Pennsylvania and the Strategic Organizing Center, a coalition of three major unions that includes the broader Service Employees International Union.
The complaint highlights UPMC’s “ongoing pattern of acquisitions and elimination of capacity in hospital and labor markets” and other efforts to limit rivals from gaining a foothold in certain Pennsylvania hospital markets.
As a result, the system has allegedly used its monopsony power—its market position as the only buyer of healthcare labor—to suppress healthcare workers’ wages and benefits, increase their workloads and limit their ability to leave for other employers, they wrote.
“If, as we believe, UPMC is insulated from competitive market pressures, it will be able to keep workers’ wages and benefits—and patient quality—below competitive levels, while at the same time continually imposing further restraints and abuses on workers to maintain its market dominance,” the unions wrote in the complaint. “Because we believe this conduct is contrary to Section 2 of the Sherman Act, we respectfully urge the Department of Justice to investigate UPMC and take action to halt this conduct.”
Pittsburgh-based nonprofit UPMC has grown to 40 hospitals thanks in part to 28 acquisitions between 1996 and 2019, the unions wrote It also chose to close four hospitals and downsize three others during the same period, which the unions said have harmed quality and were possible as a result of UPMC's potential monopoly power.
In a email statement to Fierce Healthcare, UPMC Chief Communications Officer Paul Wood said that nursing care across the system "is based on their acuity and needs, not staffing ratios, enabling us to staff with flexibility, deploying our nurses to best meet patients’ needs."
UPMC is the state’s largest nongovernmental employer with 92,000 workers. To support their monopsony claims, the unions cited this scale along with a wage study of hospital worker pay from 2008 to 2019 that found lower wages at UPMC facilities compared to reported averages among workers with similar communiting zone and cost-of-living.
Wood also said that the average wage of more than $78,000 across the system is more than competitive.
"There are no other employers of size and scope in the regions UPMC serves that provide good paying jobs at every level and an average wage of this magnitude," he said.
Additionally, the filing includes anecdotal evidence of poor benefits from former UPMC employees, a decade-long decline in staffing ratios and UPMC hospitals and claims of physician noncompete and "an alleged blacklist or 'Do Not Rehire' system" operated by the organization.
The unions supported claims of the latter with included statements from anonymous former employees, as well as with a survey conducted by the unions that found 50% of the 555 UPMC-employed respondents believed they would be blacklisted if they left their job.
Wood said there is no policy at the organization prohibiting someone who leaves employment at a UPMC facility from being hired at another.
The unions’ claims largely echo those made earlier this year in a report from anti-monopoly nonprofit group the American Economic Liberties Project, which had the backing of two Democratic lawmakers.
UPMC responded at the time by highlighting plans announced in January to increase minimum starting wages across the system to $18 by either 2025 or 2026 for non-union workers, depending on the specific location.
Wood reiterated that pledge in response to this week's complaint, alongside "above-industry employee benefits" offered by the system such as paid parental leave, backup/emergency daycare for workers, health reimbursement arrangements for lower-paid workers and healthcare premiums that "are often half of what other health systems in the area charge."
Editor's note: This story has been updated with responses from UPMC Chief Communications Officer Paul Wood.