HCA Healthcare

A putative class-action lawsuit has been filed against HCA Healthcare in North Carolina alleging the company is abusing monopoly power it adopted through its $1.5 billion acquisition of Mission Health in 2019.

The lawsuit, filed earlier this week by residents and business owners that live within Mission Health’s service area, alleges Nashville-based HCA sought the deal intending to run an “unregulated monopoly” in the Western part of the state. That, they say, has resulted in increases to insurance premiums in the region due to the health system’s inflated prices and residents’ lack of alternative options.

Court filings contend the monopoly was formed prior to HCA’s purchase of the nonprofit health system when Mission merged with the only other provider in the region, St. Joseph’s Hospital, in 1995. It further details that Mission Health was immune from anti-trust liability under a Certificate of Public Advantage agreement by which the hospital was governed with state oversight. The COPA was repealed in 2016, according to the lawsuit, and within three years HCA bought Mission Health.

The deal added six hospitals and several outpatient and surgery centers to HCA’s network and served as the company’s entrance into North Carolina. So far, the acquisition has been met with internal and community backlash with concerns HCA is jeopardizing the quality of care by cutting costs and understaffing facilities, according to multiple news reports by the Citizen Times. Multiple doctors initially left the health system and nurses organized a rally in protest of HCA’s profits. Since then, nurses have inked a deal with with the health system that include a 7 percent raise.

According to Nashville-based Gibbins Advisors, the independent monitor appointed by HCA and North Carolina Attorney General Josh Stein and charged with overseeing HCA’s commitments within the transaction, the health care giant has so far stuck to the promises it made during the original purchase agreement. Those commitments included retaining clinical services as well as investing in existing facilities and community health initiatives.

A spokesperson for HCA was unable to provide comment to the Post prior to publishing. In a statement to the Citizen Times, HCA’s North Carolina division spokesperson Nancy Lindell pointed to the company’s investments in the community so far, including $330 million in charity care and uninsured discounts in 2020, a new pediatric emergency room and a purchase of property that will host a 120-bed behavioral health hospital in the future.

"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," she said.