Competition is intensifying between two major health systems — Nashville, Tenn.-based HCA Healthcare and Cincinnati-based Bon Secours Mercy Health — as both continue to invest in growing their footprint across Central Virginia.
Bon Secours Mercy Health on Dec. 11 opened another freestanding emergency department in Ashland, Va., marking its fifth such facility in the Richmond market. The $37.5 million, 17,000-square-foot facility includes 10 patient beds and offers 24/7 emergency care and outpatient imaging services, including CT, MRI, X-ray and ultrasound. About 35 staff members — including emergency physicians and nurses — work at the facility each day.
“We are thrilled to open Bon Secours Ashland Emergency Center, meeting a critical need for residents of Ashland and Hanover County,” John Emery, president, Bon Secours Memorial Regional Medical Center in Mechanicsville and Bon Secours Rappahannock General Hospital in Kilmarnock, said in a news release. “These expanded emergency and imaging services will help decompress high volumes at Memorial Regional Medical Center and allow our patients to seek care closer to home when and where they need it.”
Bon Secours Mercy Health also operates freestanding ERs in Chester, Short Pump, Colonial Heights and Westchester, Va. The Ashland facility received state approved in 2023 — around the same time the Virginia Department of Health denied a similar proposal from HCA in the same area.
But HCA has not backed away from the region.
In October, the for-profit system is investing nearly $60 million to build three freestanding emergency rooms in Central and Northern Virginia. The expansion will increase HCA’s freestanding emergency room footprint in Virginia from eight to 11. All three sites are expected to open in 2026.
HCA also plans to open three new urgent care centers in the Richmond area over the next two years, bringing its total to 15 across the state. The new sites are located in areas of rapid population growth, according to the system.
“This is about meeting families where they are,” William Lunn, MD, president of HCA’s capital division, said in a news release. “These new emergency rooms and urgent care clinics are vital community assets that build on the exceptional care we already provide. When every second counts, we want to ensure patients get the help they need — without delay.”
HCA’s broader vision includes building a 60-bed hospital, a freestanding emergency department, medical office buildings and potentially a 90-bed expansion in the region, pending state approval. Though two of HCA’s certificate-of-need applications were previously denied, the state approved a separate application last year for a $21 million ambulatory surgery center in Hanover — viewed as the first phase of a larger hospital project.
Bon Secours Mercy Health has accused HCA of attempting to encroach on its market share, but HCA maintains its efforts are intended to expand access to care.
“The surgical center would significantly benefit our patients by improving access to high-quality surgical services from their preferred health system at a location much closer to home,” a HCA spokesperson told Becker’s.
As both systems ramp up investment in Hanover County — a growing, affluent area — their competition appears set to shape the region’s healthcare landscape for years to come.
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