HCA Healthcare, Mission Health fight new alleged proof that they control a monopoly in Western North Carolina


(Asheville Citizen-Times, Andrew Jones, 12/14/22)

HCA Healthcare and Mission Health are pushing back on claims they run a monopolistic organization in Western North Carolina, something six area plaintiffs have been trying to prove in court for more than a year.

A Dec. 5 motion to dismiss in WNC’s first antitrust lawsuit against Mission and HCA — so complex that it was in January removed from Buncombe’s Superior Court early and is currently working its way through North Carolina Business Court — claims plaintiffs’ monopoly arguments are lacking proof and fail to properly allege Mission did or is doing anything wrong when it comes to monopoly power.

Specifically, HCA and Mission are fighting new alleged proof that they control a monopoly not only in Asheville but in areas outside WNC’s largest metropolitan footprint, which the lawsuit calls the “outlying” markets. These include Yancey, Transylvania, McDowell and Macon Counties, though Mission Health claims to serve 18 counties near the mountains.

On Oct. 31, plaintiffs’ attorneys filed a revamped complaint that reiterated all the claims made when it was originally filed on Aug. 10, 2021, but also adding data from CMS Medicare discharges, an IBM Watson analysis, the North Carolina Hospital Association, hospital license renewal applications and HCA’s certificate of need application to build 67 new acute care beds at its Asheville location.

Plaintiffs’ attorneys added the new data to double down on an argument they already had made and which Business Court Judge Mark Davis found lacking in a Sept. 19 ruling, namely that HCA doing business as Mission doesn’t hold monopoly power in both Asheville and the outlying markets. Davis noted Medicare data plaintiffs were almost exclusively used to make this argument weren’t enough to prove the monopoly point. He did, however, agree that there was validity to an argument alleging HCA’s operations in WNC restrain trade and could therefore be inflating prices and stifling competition. Though Davis in his opinion dismissed the monopoly arguments, he didn’t do so with prejudice, leaving room for plaintiffs’ to make their new data-oriented argument.

But HCA — the largest hospital system in the U.S. and the purchaser of Mission Health in 2019 for $1.5 billion — in its latest motion to dismiss claims that data argument doesn’t hold water.

Part of its argument against culpability for monopoly practices lies in the fact that Mission already had massive, monopoly-sized ownership of WNC healthcare operations before it was purchased by HCA. Following the new complaint and new motion to dismiss, Davis will have an opportunity to issue a new opinion on the case, one which plaintiffs hope will accept not only the anti-competitive argument but also the monopoly case. (Source)

NCMS reported earlier this year that HCA Healthcare opened a $68 million hospital in Franklin, N.C..  Angel Medical Center is part of HCA’s Mission Health, which is based in Asheville, N.C.  For more on that story click HERE.