In 2024, Union Health announced its plan to acquire Terre Haute Regional Hospital. Late that year they filed a Certificate of Public Advantage (COPA). A COPA allows healthcare providers to merge when federal antitrust laws may prohibit the transaction, with state oversight. In Indiana, the Department of Health (IDOH) is responsible for evaluating and approving COPAs. In late 2025, IDOH approved the hospital merger under the state’s COPA framework.
The hospitals retained Kevin Pflum to analyze the potential effects of Union’s acquisition of Terre Haute Regional Hospital on labor markets in the region, including under COPA conditions. Dr. Pflum submitted a white paper to the IDOH in support of Union’s application for a COPA, expanded his analysis to relevant financials, and presented his findings to the department.
The IDOH found the benefits of the transaction, under conditions across seven categories, would outweigh any potential disadvantages from reduced competition, and the COPA grants the new systems immunity from federal and state antitrust laws.
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