On January 25, I wrote in this column: “My suggestion is that HCA Mission needs to consider a new Asset Purchase Agreement and sell the system to another provider. They paid 1.5 billion for Mission, which some critics now say was a giveaway price orchestrated by Paulus, Ball, and the Mission board. Dogwood, the recipient of the 1.5-billion-dollar sale, might very well have a role to play in the sale process.”
When I wrote the piece in January, I didn’t realize that other community leaders in WNC shared my view that it was time for HCA to sell Mission Health. In the following weeks, I met with many healthcare stakeholders concerning how to address the problems that were surfacing about Mission HCA. Last week, this group of concerned citizens and professionals rolled out Reclaim Health Care WNC. I am a charter member of the group. Please visit the Reclaim Healthcare WNC website for more information.
Reclaim Healthcare WNC has three primary goals. First, we call for replacing HCA with a non-profit healthcare provider committed to the healthcare needs of WNC residents. Put another way, the HCA corporate healthcare model does not work for Asheville and WNC. Second, we want HCA to be held accountable for harmful practices. Corporate profits have had priority over patient care. Third, we want a restoration of best-in-class medical practices across the system. For instance, providing adequate staffing to meet patient needs and maintaining top specialist doctors in critical areas such as cancer treatment and urology.
Reclaim Healthcare WNC is not the only voice demanding change for Mission HCA. The attorney general, Josh Stein, has filed legal action maintaining HCA has not lived up to the 2019 asset purchase agreement.
The new monitor tasked with verifying compliance with the asset purchase terms, Affiliated Monitors, also recently expressed compliance concerns. Now, this past week, the Dogwood Health Trust has weighed in by expressing concerns about the HCA’s quality of care and healthcare access for residents. Several months ago, the US Centers for Medicare and Medicaid Services issued an immediate patient jeopardy warning for violations of federal care standards to Mission Memorial Hospital, the flagship of the healthcare system.
While that status has been recently lifted, Mission is still under scrutiny by this federal agency. If that were not enough, Congressman Chuck Edwards just posted an op-ed in the Asheville Citizens Times stating that mega-mergers like HCA Mission increase healthcare costs and, at the same time, diminish patient care. The congressman points out that these cost increases put more pressure on federal programs like Medicare.
With all these issues now taking place, it was recently revealed that the Mission HCA Health system is the second most profitable unit in the HCA 185 hospital corporation. The net patient revenue for Mission in the past 12 months was just under 1.3 billion dollars, certainly an impressive return for HCA stockholders.
I have talked with nurses and doctors who work at Mission Memorial. They paint a very concerning picture of what is going on there. As the nurses I talked with explained, HCA reduced staffing and services while increasing prices for services in order to post those huge profits. That original cost to acquire Mission Health, 1.5 billion dollars, turned out to be a tremendous deal for the corporation and stockholders and a real sellout to the people needing healthcare in Western North Carolina.
Is more corporatization of healthcare the solution of the future? Or is there another alternative to viewing healthcare as an essential public service? In small, underserved areas, this is a huge, foreboding question.
In Highlands, we are already seeing the pressure to save our local pharmacy in the face of major insurance companies and pharmaceutical companies teaming up to price independent pharmacies out of business. Residents are routinely reminded that HCA could close our small hospital in the future, especially if it is not profitable.
I do not have the answers to these questions, but I do believe it is time for changes to healthcare in Western North Carolina. HCA selling the Mission system is a distant prospect. But hopefully, public demand and state and federal reforms will make the corporate decision-makers change how critical services are delivered. Since 2019, HCA has had a healthcare system monopoly in Western North Carolina.
The people of Western North Carolina deserve stewardship of a hospital system that is committed to the highest quality of care possible. Residents should welcome more competition and healthcare options.
Let me stress my support for the dedicated staff, nurses, and doctors who work in Mission HCA facilities. My concerns center around the corporate administration of the system