UnitedHealth and Amedisys Reach Settlement with DOJ, Clearing Path for $3.3B Merger

UnitedHealth Group and Amedisys have reached a settlement with the U.S. Department of Justice (DOJ), paving the way for their $3.3 billion merger to proceed. The agreement, filed with the Maryland district court on Thursday, requires significant divestitures to address antitrust concerns raised by federal regulators.

Settlement Details and Divestitures

Under the terms of the settlement, UnitedHealth and Amedisys will divest 164 home health and hospice locations across 19 states. This represents the largest divestiture of outpatient healthcare services ever required to resolve a merger challenge, according to the DOJ. The divested businesses account for approximately $528 million in annual revenue.

BrightSpring Health Services and Pennant Group have agreed to acquire the divested locations. BrightSpring will take on 115 sites, while Pennant will acquire 49. The majority of the divested locations provide home health services rather than hospice care.

Additional provisions of the settlement include:

• UnitedHealth must sell eight additional locations if it fails to secure regulatory approval for the agreed-upon divestitures.
• The companies must divest stakes in 10 home health and hospice joint ventures.
• A monitor will be appointed to supervise the divestiture process.
• Buyers will be provided with necessary assets, personnel, and relationships to compete effectively against UnitedHealth in overlap areas.

Amedisys has also agreed to pay a $1.1 million civil penalty for allegedly failing to fully comply with regulators during the merger review process.

Regulatory Concerns and Market Impact

The DOJ, along with four states, had previously sued to block the merger in November 2025, citing concerns about reduced competition in the home health and hospice markets. Regulators argued that the deal would have given UnitedHealth control of 30% or more of the home health or hospice market in eight states while expanding into five new states.

Assistant Attorney General Abigail Slater of the DOJ's Antitrust Division emphasized the importance of the settlement, stating, "This settlement protects quality and price competition for hundreds of thousands of vulnerable patients and wage competition for thousands of nurses."

The agreement addresses many, but not all, of the competitive concerns outlined in the DOJ's original complaint. Some antitrust experts have suggested that the settlement may not go far enough in preserving competition across all affected markets.

Strategic Implications for UnitedHealth

For UnitedHealth, the settlement removes a significant regulatory hurdle and allows the company to proceed with its vertical integration strategy in the home health sector. The acquisition of Amedisys is expected to enhance UnitedHealth's ability to provide care in lower-cost settings and gather valuable patient data.

The deal aligns with UnitedHealth's broader strategy of expanding its care delivery capabilities, particularly in light of the aging U.S. population and increasing demand for home-based care models. By integrating Amedisys into its Optum division, UnitedHealth aims to improve patient outcomes while potentially reducing healthcare costs.

However, the transaction has also raised concerns about UnitedHealth's growing market power and its ability to leverage its integrated model for financial gain, including through practices such as upcoding in Medicare Advantage plans.

As the healthcare landscape continues to evolve, the UnitedHealth-Amedisys merger represents a significant development in the ongoing trend of vertical integration within the industry. The implementation of the settlement terms and the subsequent market effects will be closely watched by industry observers and regulators alike.