On October 7, 2009, the Federal Trade Commission (FTC) announced a consent order with Carilion Clinic, the largest health care service provider in the Roanoke, Virginia area, requiring Carilion’s divesture of two recently acquired independent outpatient medical centers. The FTC had challenged Carilion’s acquisition of the two clinics as anti–competitive under Section 7 of the Clayton Act.1 Carilion will now have three months to sell the clinics and all related assets to a buyer approved by the FTC. The consent order also contains other conduct provisions regarding patient referrals, which aim to restore competition among health care providers for outpatient imaging and surgical services in the Roanoke area. This case highlights both the growing trend toward hospital ownership or affiliation with freestanding outpatient providers, clinics, and surgical centers and the government’s alertness to hospital and physician consolidation in outpatient settings (as opposed to the traditional focus on hospital mergers involving competing acute inpatient facilities).