The research, titled “Lessons Learned From HCA’s Purchase Of Mission Hospital In Asheville, North Carolina,” examined the validity of this scrutiny.
Mark Hall, a professor of law and public health at Winston-Salem, N.C.-based Wake Forest University, and his colleagues interviewed healthcare professionals in the Asheville area, including 17 clinicians who are former Mission managers or board members. The researchers also reviewed documents, financial data and literature.
Eight findings from the report:
1. After the 2019 acquisition, Mission Hospital saw its profits decrease for two years. Since then, profits “rebounded impressively, to over $100 million a year — which is several times greater than prior to HCA’s acquisition.”
2. This profit increase is largely due to decreased patient-care costs caused by a plummet in staffing ratios. Droves of specialty physicians and nurses have left, and recruitment is difficult because of the facility’s negative reputation.
3. Staffing shortages have caused “cancelled surgeries, difficulties scheduling appointments, and extended delays in obtaining laboratory results, according to various accounts from area clinicians,” according to the report. Physicians also reported a substantial increase in near-miss safety events.
4. After the acquisition, the hospital’s emergency room increased in capacity by 50%. However, the ER is overcrowded because of boarding issues, leading to patients being treated in hallways, the ambulance bay and the waiting room. There are also well-documented instances of patient harm, including death, related to the ER issues.
5. The hospital apparently requires all admitted patients to first be seen in the ER and held in the department’s boarding area, “even if they are not experiencing an emergency.”
6. Despite numerous complaints and serious concerns about quality of care, HCA Mission has largely maintained its quality ratings from US News and World Report, CMS, The Leapfrog Group and Healthgrades. Only one measure has significantly fallen: patient experience.
7. The organization has not responded to persistent efforts by clinicians to address patient safety problems.
8. The proportion of patients being treated on a charitable basis have substantially decreased. In addition, uninsured, low-income patients “no longer reliably receive care regardless of their ability to pay.”
“In sum, it is difficult to point to any concrete lasting improvements that HCA has brought to Mission Hospital,” the report said. “It is telling that, even under the most favorable viewpoints, there is no credible voice openly claiming that Asheville and western North Carolina are actually better off now with HCA at the helm of Mission.”
The report is funded by the Arnold Foundation, which “supports some ‘impact litigation,'” and some of that support goes to a law firm that is suing HCA Mission on antitrust issues.
A Mission Health spokesperson said in a statement shared with Becker’s that “this ‘research’ is neither serious nor impartial and it does not justify comment or response. It was funded by a group that is funding litigation against Mission Health, and given the financial backing of that group, it is not surprising that the ‘research’ is critical of Mission Health.”
The researchers said the study was conducted independently.
“This research team, Wake Forest University, and The Source on Healthcare Price & Competition have had no connection with that litigation,” the report said. “Also, Arnold Ventures has no control over, or even input into, how this research is conducted or how information gleaned is analyzed or reported.”
