Conditions placed on the merger that formed the Boston area’s second-largest health system—Beth Israel Lahey Health—are the latest in a series of strict state oversight actions that will shape large regional health system deals for years to come.

State attorneys general have placed stringent conditions on recent transactions that significantly consolidated healthcare services to try to level the competitive playing field. Pricing, access and quality guardrails imposed by state authorities, coupled with state legislation, are expected to ratchet up regulation of these regional tie-ups.

“As the healthcare industry matures and hospital companies continue to get larger and become more important components of their communities, the attention from attorneys general and state authorities has continued to increase,” said Jordan Shields, partner at Juniper Advisory. “These enforcement actions build on themselves.”

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