Mission Health, which operates six hospitals and health facilities in Western North Carolina and competes for medical professionals and patients with Northeast Tennessee-based Ballad Health, has signed a Letter of Intent (LOI) to merge with Nashville-based HCA.
In a letter to Asheville citizens on the newly created missionhealthforward.org website, the Mission Board wrote, “If regulatory requirements are met and we discover that joining HCA Healthcare holds the promise and potential we believe it does, Mission Health will become a member of the HCA Healthcare family later this year.”
“HCA Healthcare appreciates that Mission Health has the capacity to continue its work alone, and yet we both recognize that meeting our core missions could be achieved more effectively together,” Mission Health President and CEO Dr. Ronald Paulus said in a press release. “It is a tribute to the Mission Health board and team that we are in such a position of strength that we can make the best choice for our people, our patients and our communities.”
“The LOI is an important, proactive step to ensure Mission Health remains well-positioned to continue to meet the unique needs of western North Carolina as the healthcare environment continues to evolve.”
Despite operating without direct competition in western North Carolina under a COPA, Mission has faced increasing cost and reimbursement pressures. In 2015, the North Carolina General Assembly sunset the COPA limitations placed on Mission effective January 2018, making the Asheville-based system a much more attractive merger partner.
The HCA-Mission deal is the latest in a cascade of hospital system mergers in recent months. It follows the February merger of Carolinas Healthcare and Georgia-based Navicent Health, which created Atrium Health, the largest hospital group in the Carolinas. Wellmont Health System and Mountain States Health Alliance merged to become Ballad Health in January, leaving Mission surrounded by larger, multi-state systems.
At closing, the deal will give HCA, which employs around 240,000 people at 177 hospitals and 119 surgery centers in the U.S., its first presence in North Carolina. The transaction is subject to the negotiation and execution of a definitive agreement and to regulatory approval.