- A new class action lawsuit alleges that HCA Healthcare holds a monopoly over acute hospital services in North Carolina after acquiring Mission Health System in 2019.
- HCA has continued to use Mission's tactics of all-or-nothing arrangements with payers and gag clauses, driving up prices and insurance premiums, the complaint filed Tuesday alleges.
- The company said in a statement Wednesday that once it has been served with the lawsuit it will "respond appropriately through the legal process." The statement highlighted charity care payments in the area as well as new construction projects.
The filing claims that HCA, the largest for-profit hospital operator in the country, intentionally sought out Mission for acquisition because of its alleged monopoly status in western North Carolina counties.
It also states that HCA "has been cutting costs and staff at an alarming rate, leaving Western North Carolinians with increasingly bad healthcare at an ever-growing price."
It cites prices for cesarean sections twice the state average, for example. It further argues that the company's hospitals are not complying with price transparency requirements.
Nurses at Mission's flagship hospital, who voted to join a union a little less than a year ago, argued that staffing shortages started after the HCA acquisition. "Only a few months into the HCA buyout, we started to see dramatic decreases in the amount of staff and resources we had across the hospital," Sue Fischer, a float pool RN at Mission, said in an statement from National Nurses United.
Anticompetitive practices are seeing renewed attention under the Biden administration, which last month instructed the Federal Trade Commission to review and revise merger guidelines to further protect patients from harmful tie-ups.
And in January, the FTC sent orders to six insurers to obtain five years worth of claims data for multiple services to probe hospital acquisitions of physician groups.
The North Carolina issue began, according to the complaint, when Mission merged with St. Joseph's Hospital in 1995. At that time, it operated under a Certificate of Public Advantage, which shields mergers from federal scrutiny in exchange for prolonged state oversight.
The COPA, however, was repealed in 2016. The state monopolies have been under increasing scrutiny from the FTC.