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Epic Healthcare is being sued for “monopolist” practices, defamation, and libel.
Health data startup Particle Health filed an 81-page antitrust lawsuit in the Southern District of New York against the provider on September 23. Particle accused Epic—a growing electronic health record (EHR) and payer platform that holds more than 35% market share—of having monopoly power and trying to become the only payer platform available to hospitals and doctors’ offices by crushing the competition.
Payer platforms like Particle Health’s allow health insurance providers to access patient medical records directly from a healthcare provider’s EHR platform and run analytics on their customers’ health trends. Particle’s website says its platform contains more than 320 million patient records.
Epic, which stores medical records for more than 325 million patients, according to its website, created a payer platform of its own called Epic Payer Platform in 2021.
“The impact on Particle of Epic’s anticompetitive conduct has been severe and threatens its very existence,” the startup claimed in the suit. “If left unfettered, Epic’s conduct will snuff out meaningful competition in the still-fledgling payer platform market.”
Why sue? In 2023, Particle Health reportedly developed the first third-party payer platform that was compatible with Epic’s EHR system, per the suit. Then, Epic “decided that it had had enough of fair competition,” Particle alleged.
“Without meaningful competition, Epic will be allowed to provide a worse product for higher price, which will in turn have cascading effects on the scope and price of plans that payers provide,” the complaint read.
Among other tactics, Particle claimed that Epic “coerce[d]” payers and providers to stop using Particle by cutting Particle’s customers off from Epic-stored records.
Epic also allegedly put out statements that Particle had “security and privacy risks,” according to the suit. In March, the company filed a formal complaint against Particle with Carequality, a private nonprofit that oversees health data exchanges and ensures interoperability throughout the US healthcare system. According to the current suit filing, Particle claimed that while Carequality had taken the startup’s side, it still issued a “corrective action plan” that “gave Epic much of what it wanted.”
Particle holds that this tanked the startup’s reputation and revenue, dropping it to one-third of its previous projections in an ongoing downward trend. “Epic destroyed public trust in its only meaningful competitor to date in an industry where privacy and security are paramount concerns,” the suit read.
Rob Klootwyk, Epic’s director of interoperability, said in a statement shared with Healthcare Brew that its EHR software is “open and interoperable” and “Particle’s claims are baseless.”
He added that Particle’s complaint “mischaracterizes Carequality’s decision,” reiterating Epic’s complaint that the Particle platform had security risks. “Particle’s unlawful actions on the Carequality health information exchange network violated HIPAA privacy regulations,” he said.
Particle is seeking monetary damages and asking the government to step in to halt Epic’s “anticompetitive” behavior.