‘Inevitability of consolidation’ motivated nonprofit Mission Health to open talks with HCA
For-profit hospital giant HCA has entered into discussions to acquire Mission Health, a nonprofit six-hospital system based out of Asheville, North Carolina, in a deal Mission admitted may result in some jobs being eliminated.
The two systems announced on March 21 they had signed a letter of intent to begin exclusive acquisition talks. John Ball, MD, board chair of Mission Health, said it was “confident that HCA Healthcare is the right and best choice for Mission’s team members and providers, its patients and the communities we are privileged to serve.”
In a FAQ released along with the press release, however, Mission said the flurry of mergers and acquisitions (M&A) activity among hospitals made it “essential” for the western North Carolina system to seek a partner.
“Given the inevitability of consolidation, we wanted it to be our choice long before we are forced to make one,” the FAQ said. “It’s from this position of strength that we are able to ensure that our selected choice is as invested as we are in our mission, people, patients, providers and communities.”
Mission made the argument HCA will be the right fit for the area because the proposed acquisition agreement includes commitments for HCA to make “substantial annual investments” in patient care and to maintain Mission’s current charity care policies. There has been disagreement among academic studies as to whether for-profits like HCA provide less charity care than nonprofits. One benefit of the system becoming for-profit, Mission said, would be generating additional tax revenue for the region.
Approximately 12,000 people work at Mission, including more than 1,000 physicians. There have been cutbacks in staff in recent years and Mission said some changes to staffing—though not necessarily overall reductions—should be expected if the HCA acquisition is completed.
“While some positions will likely change or be eliminated over time due to changes in market demand as they have been for years, we do not anticipate significant changes, but beyond what we typically experience or that would be required as we evolved and expanded our organization alone, without an HCA Healthcare relationship,” the Mission FAQ said. “Additionally, HCA Healthcare plans to invest and grow here so, importantly, we do expect new jobs and new opportunities to be created—particularly for clinical staff.”
In a separate op-ed on the deal published in the Asheville Citizen Times, three physician leaders from Mission made the case that being acquired by HCA will mean not only additional efficiencies through its larger purchasing power, but also “important clinical benefits” like extra resources to focus on the social determinants of health.
“We have a match that allows us to maintain and even improve the high-quality care at the bedside our patients have come to expect and deserve,” wrote Mission’s chief medical officer William Hathaway, MD, president David Franklin, MD, and chief of staff Alexander Schneider, MD.
Other hospitals haven’t shared this positive view of HCA and for-profit hospitals in general. For example, when trustees for the Indian River Medical Center in Vero Beach, Florida were selecting a company to take over the public hospital, HCA’s bid was passed over in favor of Cleveland Clinic, despite HCA offered $109 million more. Hal Brown, MD, the hospital’s chief of staff said of HCA: “They don’t tend to put the patient first.”
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.