Wake Forest Report Reveals: HCA’s Acquisition of Mission Health Failed to Deliver Lasting Improvements

By Andrew R. Jones

Asheville Watchdog

The sale of Mission Health to HCA Healthcare was controversial and conducted without public input. Many feel it hasn’t led to the promised improvements for Mission Hospital, according to a recent study from Wake Forest University.

While HCA initiated some changes in western North Carolina’s healthcare system, most were either already planned or required by the state attorney general at the time of the sale in 2019. The study remarks, “It is telling that there is no credible voice claiming that Asheville and western North Carolina are better off now with HCA managing Mission.”

The report suggests that other states might improve regulations on hospital sales. They could give more power to attorneys general or modify laws meant to ensure fair competition among healthcare facilities. This could include requiring quality of care promises in sales or making the process more transparent.

When asked for comments on the study, Mission Health spokesperson Nancy Lindell declined, noting her previous criticisms of it, citing conflicts with the funding source.

Following the sale, Attorney General Josh Stein set 15 conditions to maintain service levels for a decade. However, there were no specific quality care stipulations. Stein has since filed a lawsuit against HCA and Mission, claiming they failed to meet the sale’s terms regarding cancer care and emergency services. HCA argues that the agreement did not ensure a specific quality of care.

Proposed legislation aims to tighten oversight of hospital sales and give attorneys general more authority during reviews. This could lead to bipartisan support, despite anticipated changes to the bill.

Since the deal, many doctors and nurses have left Mission, causing public outcry. A coalition of doctors, advocates, and politicians is now seeking a new nonprofit buyer for Mission. Additionally, the Centers for Medicare & Medicaid Services recently placed Mission Hospital under scrutiny due to serious care deficiencies.

Previous studies on the sale highlighted cuts in charity care and staffing issues post-acquisition. Despite these setbacks, some argue there have been a few positive outcomes, like the establishment of Dogwood Health Trust, a charitable foundation aimed at improving community health and welfare. The long-term effects of this foundation remain to be seen.

HCA has also launched new facilities, including a behavioral health center and emergency department. Although staffing has decreased, all five regional hospitals remain operational as per the commitments made to the state.

During crises such as the COVID-19 pandemic and Tropical Storm Helene, HCA’s resources helped Mission to respond effectively, securing supplies when many other hospitals struggled. Still, there have been issues with supply shortages, indicating that challenges persist.

Critiques of HCA and Mission may, in some cases, overlook the broader difficulties hospitals face today. The report suggests that some reactions might stem from unrealistic expectations of healthcare services and performance.

This discussion around Mission’s sale and ongoing challenges can serve as an important case study for healthcare policies nationwide. Mark Hall, who led the study, emphasizes that lessons learned here might apply broadly, especially as states consider how to regulate such crucial community resources.

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