HCA hit with antitrust lawsuit

A group of Western North Carolina residents has filed a class-action antitrust lawsuit alleging that Nashville, Tenn.-based HCA Healthcare engaged in anticompetitive tactics that resulted in higher prices and lower quality care for patients.

The 87-page lawsuit, filed in Buncombe County on Aug. 10, alleges that after HCA purchased Asheville, N.C.-based nonprofit Mission Health in 2019, the for-profit parent company used a monopoly in Ashville to raise prices for both inpatient and outpatient care. 

In one instance cited in the lawsuit, the plaintiffs claim that HCA currently charges more than two times the state average for a C-section without complications.

"This price disparity — one matched and exceeded by numerous other procedures — can only exist because of the system's unbridled monopoly power and its status as a 'must have' system in Western North Carolina," the plaintiffs claim. 

Further, the plaintiffs claim that HCA holds a 70 percent or more market share for inpatient services in seven North Carolina counties, including Yancey, where it has a 90.9 percent market share, and Madison, where it has a 90 percent market share.

"Because insurers and consumers in the region have no choice but to use HCA, HCA has free rein to dictate the prices it charges insurers and consumers while at the same time undermining quality to cut costs," the lawsuit claims.

The plaintiffs also claim that HCA has been cutting costs and staff "at an alarming rate," allegedly leaving Western North Carolinians with worse healthcare. 

"The plaintiffs allege that an out-of-state corporation has used its market power to cut quality and raise prices, harming doctors and consumers," said Mona Lisa Wallace, one of the attorneys representing the plaintiffs. "Mission Health was once the crown jewel of North Carolina's healthcare system. In filing this action, the Plaintiffs seek to have HCA live up to its promises of providing quality affordable healthcare in Western North Carolina."

The plaintiffs are asking the court to certify the class, declare that HCA has monopolized the local market and award damages, among other requests.

Nancy Lindell, a Mission Health/HCA Healthcare North Carolina Division spokesperson, told Becker's Hospital Review that HCA will respond through the legal process once it is served with the lawsuit.

"Once we have been served with the lawsuit, we will respond appropriately through the legal process," Ms. Lindell said. "We are committed to caring for Western North Carolina as demonstrated through more than $330 million in Charity Care and uninsured discounts we provided in 2020, expansion of hospital services including the opening of the North Tower, a new Pediatric ER, and securing land for a new 120-bed behavioral health hospital. Further, we have invested in our colleagues with onboarding nearly 1,200 new members this year and providing more than $3 million in student loan and tuition reimbursement in 2020. Mission Health is committed to the health and well-being of every person who comes to us for care and we are proud of our dedicated hospital teams that are facing the many challenges of this pandemic and the exceptional care they have provided to our patients."

The plaintiffs are represented by Wallace & Graham in Salisbury, N.C., and Fairmark Partners, based in Washington, D.C. 

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