Mission Health may be acquired by Hospital Corporation of America

ASHEVILLE — Mission Health, the area's largest employer with a sizable footprint in Western North Carolina, has signed a letter of intent to be acquired by HCA Healthcare Inc., the organization said in a news release late Wednesday.

Mission said its board voted unanimously to execute the letter of intent with the Nashville-based for-profit health care company, which operates 177 hospitals and 119 surgery centers in the United States as well as the United Kingdom. The nonprofit community hospital group said the decision is based on its "long-term vision and commitment to preserve and expand" the organization's quality of care in what it calls "a rapidly consolidating healthcare industry."

Mission Health Board Chair Dr. John R. Ball added the board is "confident that HCA Healthcare is the right and best choice for Mission’s team members and providers."

“We are extremely excited about this unprecedented opportunity to create an even stronger cornerstone of value, access and quality."

In a letter to Mission's staff, obtained by the Citizen Times, CEO Dr. Ron Paulus said if joining HCA holds "the great promise and potential that we believe it does," Mission will become a member of the company sometime in this calendar year. It is anticipated that an acquisition would require a three-year transition period prior to any integration of the two physician groups.

"This is great news for our people, our patients and the communities we are privileged to serve," Paulus said.

The deal is subject to to the negotiation of a definitive agreement and applicable regulatory approval, Mission said. Mission launched a website —missionhealthforward.org — with the announcement to provide updates on the merger as they become available.

If it goes through, the move would place Mission under the umbrella of the for-profit HCA company, which has 240,000 employees throughout its system and navigate more than 27 million annual patient encounters, a fact sheet provided by the company shows.

It is a significant move for Mission, which has been in business in some form since the late 19th century in Western North Carolina. Mission now is a seven-hospital health system that serves the 18 westernmost counties of the state including locations in Asheville, Brevard, Franklin and Marion. Mission provides care to about 1 million patients annually.

Paulus said in his email the reason for the decision is "as simple as it is compelling."

"We strongly believe that we can do much more together than we could alone," he wrote, "and that this is an exciting next step in achieving our true mission, which is to improve the health of the citizens of western North Carolina and the surrounding region."

A spokesperson from HCA Healthcare Inc. did not immediately respond to a reporter's email request for comment.

Mission has had its share of difficulties in recent years. In April 2017, Mission discontinued labor and delivery services at Angel Medical Center, to the dismay of residents in Macon County and beyond. At the time, Paulus said changes to the Affordable Care Act, along with cuts to Medicare and Medicaid, and the state’s refusal to expand Medicaid, put significant financial pressure on the health system.

About 77 percent of the patients at Angel were either uninsured or insured by Medicaid or Medicare. That is slightly above the system average.

In June, Mission said it would move labor and delivery from its Spruce Pine hospital to McDowell Hospital in the fall, citing too few patients to support those services.

It also issued a notice of termination in July to Blue Cross Blue Shield of North Carolina over concerns of rising health care costs. Mission left Blue Cross NC's network in October, meaning about 260,000 people in the region who are insured with Blue Cross would have to pay out-of-network rates to receive care at Mission's facilities.

The two sides later struck a deal for Mission to return to the network in December.

Among the benefits Mission perceives from the new partnership are that HCA "shares our values," has expressed an interest in investing in Mission and its communities as well as adding additional resources to benefit patients.

Mission, itself has been through an extensive reinvestment process with its hospitals dating back several years. It recently opened its new $46 million McDowell Hospital in Marion and is on track to finish its $400 million project creating the Mission Hospital for Advanced Medicine in Asheville.

"It is important to us that HCA Healthcare expresses a commitment to supporting our clinical best practices and our communities’ values," Paulus was quoted as saying in a news release. "The recognition HCA Healthcare continues to earn for being one of the world’s most ethical companies is compelling."

Paulus became CEO of Mission on Sept. 1, 2010. He was the first physician in that position in the hospital’s history. At the time, he was executive vice president of clinical operations and chief innovation officer at Geisinger Health System in Pennsylvania.

Mission Board Chair George Renfro referred to Paulus as a "game changer."

"I think he understands what you have to do, where you have to go, and how you have to do things in order to deal with the future of health care," he said.