TOWN OF WALLKILL – Garnet Health still anticipates signing an agreement by the end of the year to finalize an affiliation with Montefiore Health System, Inc.
However, the transaction will be closely monitored by, among others, Hudson Valley elected officials and healthcare unions. When reached for comment by Mid-Hudson News, Congressman Pat Ryan (D, NY-18) said that he expects formal guarantees that “there will be no reductions in care, increased costs or layoffs for Hudson Valley families.”
Ryan has been a vocal critic of Optum Health, a subsidiary of UnitedHealth Group, which bought Crystal Run Healthcare in 2023, referring to it “as a monopoly that directly hurts everyone in our community.” He has brought his concerns about Optum to Attorney General Pam Bondi.
UnitedHealth is also facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctors’ offices. Optum has purchased medical practices across the Hudson Valley, with market control of more than 2,500 providers at CareMount Medical and Crystal Run Healthcare and 10 percent of doctors nationwide.
“If our community is harmed in any way like we saw with Optum, I will not hesitate to hold those responsible accountable,” Ryan said of the potential Garnet-Montefiore affiliation. “As with all mergers, especially ones pertaining to something as personal and important as our community’s health care, it is absolutely vital that these large health systems take all necessary steps to ensure care quality and access do not diminish whatsoever.”
Assemblyman Jonathan Jacobson has introduced two bills to limit monopolistic practices and ensure a fairer market for smaller, independent medical providers, which he said “ultimately leads to better prices for patients.”
“When insurance companies and medical providers merge, they dominate local markets and put the squeeze on smaller providers,” Jacobson added. “The outcome is obvious: less competition means fewer options for patients, which leads to higher prices. This has already been happening in the Hudson Valley with Optum.”
Garnet emphasized that the impending deal with Montefiore, which operates 10 hospitals and more than 200 outpatient sites, is not an acquisition. Garnet anticipates the affiliation to result in enhanced access to high-quality care, strengthened and expanded clinical services, and broaden access to specialty care for more than 500,000 residents served throughout Orange and Sullivan counties and surrounding areas.
Healthcare and legal experts told Mid-Hudson News that any hospital deal of this magnitude could be highly scrutinized due to the recent consolidation of healthcare in Orange County and potential antitrust law issues. Consolidation of healthcare may have negative economic and population health impacts in a region, primarily by increasing prices and reducing access to care.
Angela Lane, Vice President for the Hudson Valley, 1199SEIU United Healthcare Workers East, said, “We will await details and engage with elected and community allies as needed to protect care and jobs.”
She said Garnet Catskill “has already lost services, including no longer having an infectious disease specialist on site.”
Lane added that Garnet Catskill” is also among the most vulnerable New York State hospitals if the federal healthcare cuts in the disastrous OBBB (One Big Beautiful Bill) go through. Our top priority is access to essential care and good jobs in the region — our members are watching closely.”
A spokesperson for Montefiore Health System did not immediately return a phone call seeking comment for this story.
The proposed Garnet-Montefiore deal still requires regulatory approval. A spokesperson for the State Department of Health (DOH) said that the agency has not received a Certificate of Need application or other pertinent application to implement the affiliation between Garnet and Montefiore.
A Garnet spokesperson said that they are still working through the due diligence process on the affiliation with Montefiore.
“Once completed, the next step would be to sign a definitive agreement, which we anticipate finalizing by the end of the year,” the spokesperson said. “Following that, we will begin preparing the required filings and documentation for submission to the appropriate regulatory and oversight agencies, which require their review and approval before the affiliation can proceed.”
That process could take up to two years.