Competition & Markets Authority
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Healthcare deal could lead to higher costs for NHS

Deal to combine healthcare tech and data specialists could lead to lower quality and more expensive software options for the NHS.

An initial investigation by the Competition and Markets Authority (CMA) has found UnitedHealth’s £1.2bn deal to buy EMIS could reduce competition leading to worse outcomes for the NHS and ultimately patients and UK taxpayers.

The NHS is increasingly seeking digital and data-driven solutions to help improve the delivery of healthcare in the UK. EMIS is a large and established supplier of data management systems to the NHS. This includes supplying the electronic patient record system used by the majority of NHS GPs in the UK. Optum, part of the US healthcare giant UnitedHealth, currently supplies software used by GPs when prescribing medicines, as well as data analytics and advisory services that the NHS uses to help improve overall healthcare and health service provision (Population Health Management).

As part of its Phase 1 investigation the CMA looked into these services and how UnitedHealth’s purchase of EMIS may impact competition to develop and supply digital and data analytics products to the NHS.

The investigation found competition could be substantially reduced specifically in the Population Health Management and medicines optimisation software markets (which enable the safe and effective use of medicines).

The CMA is concerned the deal could impact services provided by Optum’s competitors. Optum and its competitors rely on digital connections to the data that EMIS holds, and integrations with EMIS’s electronic patient record system. Optum could, if the merger went ahead as planned, choose to limit these connections and the CMA believes this could unfairly undermine competing businesses. The NHS, as the customer of these products, could then face fewer options, and higher prices or lower quality offerings.

Sorcha O’Carroll, Senior Mergers Director at the CMA, said:

The NHS and the millions of patients under its care depend on critical behind-the-scenes technology to ensure people are looked after and receive the treatment needed to get better.

This deal could see the NHS lose out on the benefits of competition, including innovation in these products and services and getting better value for money. UnitedHealth has the opportunity to address our concerns, otherwise it will progress to a more in-depth investigation.

UnitedHealth and EMIS have 5 working days to offer legally binding proposals to the CMA to address the concerns identified. The CMA would then have a further 5 working days to consider whether this address its concerns, or if the case should be referred to the next stage, Phase 2 investigation.

More information can be found via the Optum / EMIS case page.

Notes to Editors

  1. Optum is part of United Health Group Incorporated. EMIS Group Plc is based in the UK.
  2. The CMA’s Phase 1 investigation started on 20 January 2023 after the companies announced the acquisition in 2022.
  3. The CMA is, in most cases, required to issue a Phase 1 decision within 40 working days. Merging parties are required to formally offer proposed remedies (undertakings in lieu of a referral to a Phase 2 investigation (UILs)) within 5 working days after receiving the CMA’s Phase 1 decision and the CMA then decides, within 10 working days after the Phase 1 decision, whether to provisionally accept the UILs offered. The CMA then has 50 working days (subject to an extension of up to 40 working days) to consider whether to finally accept these remedies.
  4. A further explanation of what Population Health Management can be found on the NHS website.
  5. For more information, journalists should contact the CMA press office by email on or by phone on 020 3738 6460.
  6. All enquiries from the general public are directed to the CMA’s General Enquiries team on or 020 3738 6000.


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