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UnitedHealth Group’s Optum has bought an untold number of physician practices over the years. It either owns or is affiliated with over 90,000 providers — almost 10% of all U.S. physicians.

That’s mostly happened quietly. But a new Optum purchase in Oregon is getting outsize scrutiny from state regulators — a trend experts say is actually on the rise.

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Oregon is at the forefront of the push for more scrutiny; it already has some of the strongest health care market oversight laws in the nation. But state legislatures in Illinois, Minnesota, and New York approved similar oversight programs last year, meaning deals in those states will start getting more scrutiny soon. And five more states, Vermont, Washington, Pennsylvania, Indiana, and New Mexico, are already looking at legislation to start or expand their own programs.

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