Salem Health is accused of monopolizing cardiac medicine

The largest independent heart center in the mid-Willamette Valley is suing Salem Health, accusing the nonprofit of monopolizing cardiac care in the Salem region and trying to force competitors out of the market.

According to the lawsuit, the hospital pressured patients to change doctors while they were in hospital, restricted referrals and access to information about independent cardiologists, and spread misinformation about the hospital in the local health care system.

The Oregon Heart Center's lawsuit, filed Sept. 11 in Marion County District Court, also names Salem Health CEO Cheryl Wolfe, who is accused of disparaging the clinic in a newsletter to local medical professionals.

The lawsuit seeks a total of $15 million in damages from Salem Health, including $10 million for Salem Health's alleged attempts to monopolize the cardiology market and $5 million for defamation.

The clinic accuses Salem Health of violating state antitrust regulations. The lawsuit asks the court to order Salem Health to stop its anti-competitive practices and attempts to “drive OHC out of business.”

READ IT: Oregon Heart Center's lawsuit against Salem Health

The Oregon Heart Center “felt compelled to file this lawsuit to stop Salem Health's ongoing campaign of exclusion and intimidation that has caused and will continue to cause serious harm to the heart center and the local health care system,” the lawsuit states.

Salem Health spokeswoman Lisa Wood said in an emailed statement to the Salem Reporter on Monday that the hospital is offering more cardiology services to meet community needs.

“Expanding access to excellent, patient-centered cardiology care is good for patients and for our community. It's unfortunate that our colleagues at Oregon Heart Center don't see it that way. We have a long history of supporting and collaborating with community physicians to provide high-quality, accessible care,” Wood said.

She did not respond to specific questions about the lawsuit's claims, such as whether Salem Health had removed independent cardiologists from its website or terminated a lease at the Oregon Heart Center in Dallas.

“We are disappointed that Oregon Heart Center has chosen to engage in time-consuming litigation that diverts resources and attention from patient care rather than resolve its concerns with Salem Health on a collegial basis, especially given that we had agreed to mediation,” Wood said.

Oregon Heart Center attorney Stanton Gallegos said in an email to the Salem Reporter on Monday that he would not comment on the lawsuit beyond the information contained in the complaint.

According to the lawsuit, the Oregon Heart Center employs 12 physicians who serve the greater Salem area. Its headquarters are at 610 Hawthorne Ave. SE, with additional offices in Dallas, Stayton and Grand Ronde.

According to the hospital's website, Salem Health employs over 5,800 people in Salem, making it the city's largest private employer. It also operates the state's busiest emergency department. According to the Oregon Health Authority, Salem Hospital and Salem Health West Valley Hospital reported net revenue per patient of over $1 billion in 2023.

Salem Health has been expanding in recent years, adding 150 beds with a new hospital tower in 2022. Last fall, it acquired Hope Orthopedics and its three clinics, becoming the region's primary provider of bone care, which the lawsuit cites as an example of the hospital's consolidation efforts.

According to the lawsuit, Salem Health and Oregon Heart Center had existed in Salem for many years until recently. Cardiologists from the clinic had served in senior roles at Salem Hospital with the shared goal of improving health care for the community. The two organizations had entered into an agreement to share patient records.

Wolfe said in a June “Common Ground” newsletter to Salem Health employees and administration, cited in the lawsuit, that the agreement would not be renewed when it expires next year. The lawsuit claims the newsletter reaches most people who work in health care in Salem.

“Despite past disagreements, Salem Health has a long history of supporting and collaborating with local practices to improve care. However, (Oregon Heart Center) has demonstrated a persistent unwillingness to work with Salem Health. In addition, it has disparaged the quality of Salem Health and its physicians. Publicly disparaging the quality of our surgeons and CT program without factual basis will not be tolerated,” Wolfe wrote.

In 2022, Oregon Heart Center and Cascade Cardiology opened a new surgical center. Salem Health would partner with the center, the lawsuit says, which would provide another option for outpatient surgery in the community.

Salem Health wanted majority control of the surgical center, the lawsuit says, and threatened to drive out the independent practices if they did not agree. When the other clinics refused, Salem Health withdrew from the plans, the lawsuit says.

“After years of unsuccessful attempts to eliminate competition, Salem Health is now using its monopoly in hospital care and anti-competitive agreements with providers and insurers to try to force (Oregon Heart Center) and other outside cardiologists out of the market or force them to capitulate to Salem Health's attempts to take over their practices,” the lawsuit states.

The lawsuit alleges that Salem Health pressured its providers not to refer patients to Oregon Heart Center cardiologists and set up its referral system to refer patients to Salem Health cardiologists by default.

According to the lawsuit, this also applies when a patient comes to the emergency room, provided the cardiologist on call is independent. According to the lawsuit, the hospital also pressured patients to transfer from the Oregon Heart Center to Salem Health.

“Salem Health is taking these steps with the goal of acquiring or putting out of business the two remaining independent cardiology practices,” the lawsuit states.

Wolfe is being sued for her statements in the newsletter “Common Ground”.

In the newsletter, Wolfe said Salem Health had seen a decline in heart surgeries because independent cardiology groups had begun referring patients to Portland.

“The change in this referral pattern occurred when Salem Health and the independent cardiology practices could not agree on a joint venture and Salem Health opened its own cardiology practice,” Wolfe said in the newsletter.

Wolfe said in the newsletter that Salem Health will not renew its contract with the Oregon Heart Center to share patient records because “the Oregon Heart Center (OHC) does not share our vision of a successful, sustainable, local health care system that meets the long-term needs of our community.”

The lawsuit alleges that terminating the contract will result in longer wait times for patients. Wolfe said in the newsletter that the clinic's providers will still have access to Salem Health's records, but the hospital will no longer support the clinic's system.

That newsletter resulted in canceled appointments and lost referrals at Oregon Heart, the lawsuit says.

The lawsuit alleges that she told community providers during negotiations for the new surgery center that the heart center was greedy.

The Oregon Heart Clinic also alleges that Salem Health and Wolfe blamed the clinic for the suicide of a former Salem Health surgeon. The complaint did not provide details about when this occurred.

The clinic claims it has already lost patients and hiring opportunities because of Salem Health's statements.

“Salem Health has made clear that its conduct is not about cooperation or about doing what is best for the Salem healthcare community. It is about one thing: ensuring that surgical procedures are performed by Salem Health providers in Salem Health facilities to increase profits,” the lawsuit states.

Contact reporter Abbey McDonald: [email protected] or 503-575-1251.

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