The Federal Trade Commission has reached a settlement with U.S. Anesthesia Partners over allegations that the private equity-backed provider consolidated control of the anesthesia market in Texas and raised prices.
According to an FTC press release issued Thursday, the settlement remains confidential as discussions on implementation are ongoing. The agency stated that the agreement is intended to restore a competitive market structure and noted that it may relitigate the case if USAP fails to comply with the terms.
USAP denied wrongdoing and said it agreed to the settlement to avoid the cost and disruption of extended litigation.
The FTC’s complaint, filed in 2023, alleged that USAP—backed by private equity firm Welsh, Carson, Anderson and Stowe—acquired large anesthesia practices across Texas as part of a strategy to establish market dominance. The agency further alleged that USAP and its backers used that position to demand higher prices for anesthesia services, resulting in increased healthcare costs for patients.
The FTC previously reached a settlement with Welsh Carson in early 2025. That agreement did not require the firm to admit liability or pay monetary penalties but restricted its involvement with USAP.
In a statement, USAP Physician and Board Chairman Scott Holliday said: “there are uncertainties in any legal proceeding and this exceptionally prolonged litigation has required enormous time, energy, and financial commitments. In considering the best interests of our patients, clinicians, and hospital partnerships, we felt it was important to resolve this now so that USAP can remain laser focused on providing high-quality anesthesia services to our communities.”
USAP stated that the settlement will not require an admission of wrongdoing.
A federal judge had previously dismissed the FTC’s lawsuit against Welsh Carson, ruling that private equity firms are not responsible for the actions of their portfolio companies. The FTC later secured a settlement with the firm after indicating it would pursue the matter in its administrative court. The case against USAP remained active until the current agreement.
New York-based Welsh Carson established USAP in Texas more than a decade ago. By 2023, the provider had expanded into 12 states and Washington, D.C., through acquisitions of anesthesia practices. USAP is also backed by Berkshire Partners and GIC Capital. The company currently operates in nine states, according to its website.
The FTC stated that the USAP settlement “will be consistent with longstanding FTC settlement best practices.”
Background of FTC Allegations
The FTC originally filed the case in 2023, accusing U.S. Anesthesia Partners of executing a long-term strategy to consolidate anesthesia practices across Texas. According to the FTC, this “roll-up” approach reduced competition and enabled the company to increase prices, costing patients tens of millions of dollars annually.
The case was brought under U.S. antitrust laws, particularly those designed to prevent monopolistic behavior and protect competitive markets. Regulators argued that consolidation in the anesthesia sector created barriers for independent providers, limiting competition and potentially driving up healthcare costs for patients and insurers alike.
Role of Private Equity in Healthcare Consolidation
A central issue in the case involved the role of private equity investment in healthcare. Over the past decade, private equity firms have increasingly backed physician practice roll-ups, aiming to create large, integrated networks. While these strategies can improve operational efficiency, critics argue they may also reduce competition if not properly regulated.
Impact on Patients and Providers
The outcome of the case could have meaningful implications for both patients and healthcare providers. Reduced competition in specialized medical services often leads to higher procedure costs, which can translate into increased insurance premiums and out-of-pocket expenses. Independent providers may also face challenges entering or remaining in concentrated markets.
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