Mission Health announces acquistion talks with HCA Healthcare

Jason Sandford

Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.

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Mission Health has signed a letter of intent to be acquired by HCA Healthcare, a Nashville-based health care giant that is a for-profit operator of about 300 hospitals and surgery centers across the U.S.

If the acquisition is approved, Mission Health, which operates as a not-for-profit, would move to a for-profit entity.

Here’s the press release from Mission:


Mission Health’s Board of Directors today announced that it has signed a Letter of Intent (LOI) to enter into exclusive discussions to join HCA Healthcare, a Nashville, Tennessee-based company founded 50 years ago by two physicians. The Board’s unanimous decision to execute the LOI with HCA Healthcare reflects its long-term vision and commitment to preserve and expand Mission Health’s world-class quality of care within a rapidly consolidating healthcare industry.

HCA Healthcare is one of the nation’s leading providers of healthcare services and uses its extensive resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine. 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. A key component of the proposed agreement is the establishment of a new foundation that would provide substantial annual investments dedicated to improving the health and well-being of the citizens of western North Carolina. In addition, as part of HCA Healthcare, Mission Health is expected to generate millions of dollars in tax revenues for the area.

“The Board, all of whom are community members who care deeply about ensuring access to high quality care for the people of western North Carolina for generations to come, is confident that HCA Healthcare is the right and best choice for Mission’s team members and providers, its patients and the communities we are privileged to serve,” said Mission Health Board Chair John R. Ball, MD. “We are extremely excited about this unprecedented opportunity to create an even stronger cornerstone of value, access and quality.”

“HCA Healthcare is a leading healthcare operator that offers advantages on a scale that would be difficult, if not impossible, to achieve otherwise,” Dr. Ball said. “As important, the newlyformed foundation will be life-changing for the residents of our region, providing tens of millions of dollars annually in new support for the most vulnerable.”“Mission Health has a more than 130-year tradition of caring for communities throughout western North Carolina, and we are excited to formalize discussions with them about how we can help continue their impressive legacy,” said Milton Johnson, HCA Healthcare’s chairman and CEO. “As a healthcare provider founded by physicians 50 years ago, we appreciate the way Mission Health has served western North Carolina with a level of excellence that has earned national recognition as one of the top 15 healthcare systems in the country. We appreciate the opportunity to discuss becoming an integral part of their community.”

In making the announcement, Mission Health’s Board Vice Chair, John W. Garrett, MD, noted that even though HCA Healthcare is one of the nation’s leading health system operators, it does not currently have operations in North Carolina. “HCA Healthcare is attracted to Mission Health for many reasons, including the reputation of Mission Health clinicians and broader team to deliver best-in-class care and patient outcomes and our shared commitment to innovation. When combined with the ability of the newly formed foundation to enhance access in underserved communities and to invest in solving some of healthcare’s most complex and intractable problems – health risks that are beyond the reach of traditional medicine – it’s an ideal opportunity for our community,” said Dr. Garrett.

“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. 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,” said Mission Health President and CEO Ronald A. Paulus, MD.

“We are excited to be considering joining HCA Healthcare and benefitting from its caliber and exceptional capabilities in research, clinical trials, data analytics, graduate medical education and more. We believe that HCA Healthcare uniquely provides the experience, scale and resources that will enable Mission Health to enhance and expand our services in western North Carolina,” said Dr. Paulus. “In return, joining HCA Healthcare would allow Mission Health to share our quality and clinical outcome best practices with the broader HCA Healthcare family to the benefit of communities across the nation.”

“It is important to us that HCA Healthcare expresses a commitment to supporting our clinical best practices and our communities’ values,” Dr. Paulus added. “The recognition HCA Healthcare continues to earn for being one of the world’s most ethical companies is compelling.” For the past nine years, HCA Healthcare has been ranked as one of the World’s Most Ethical Companies by the world leader in business ethics, the Ethisphere Institute.

Mission Health is the only health system in North Carolina to be named one of the nation’s Top 15 Health Systems by Truven Health Analytics, an IBM Company, and the only health system in the nation to be named a Top 15 Health System in five of six years.

The transaction contemplated by the LOI is subject to the negotiation of a definitive agreement and applicable regulatory approval.

To learn more and stay informed, the public is invited to visit missionhealthforward.org.

Jason Sandford

Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.

  • 1

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  1. FREDIRICO G Lorca March 25, 2018

    I SUGGEST THOSE WITH A STAKE IN OUR COMMUNITY CONTACT Attorney General for State of N.C,Josh Stein,who will have final say on the acquisition and privatization of Mission Hospital,and provide opinions but specially facts if you are involved in any facet of health care or other aspect of our community that will be impacted.Think about it.Starting with Law enforcement,health careers.Crime WIIL INCREASE,JAILS WILL OVERFLOW.. Think

  2. Nathan March 24, 2018

    When a non-profit business is bought by a for-profit business, who gets the money? Hard to believe there aren’t some insiders getting *seriously* rich off this deal, including Paulus and the board.

    1. MIke March 28, 2018

      yup, my thought exactly. The current CEO and board have been running Mission as if it was a for profit entity for years (acquiring smaller doctor offices, expansion, etc.) and not at all looking after their stakeholders as Not for profits should. I definitely believe this was their end game, build up a product and sell it out (ie: Wicked Weed) Someone should read and follow the money, and I bet they were a little off their mission as a not for profit…

  3. luther blissett March 23, 2018

    Mission’s COPA formally expired in January. Did the legislators who supported COPA repeal in 2015 anticipate Paulus and the board cashing out?

  4. Das Drew March 22, 2018

    No bueno.

  5. Anon March 22, 2018

    Some food for thought:
    1. For profits open the door for changes to CONs
    2. Paulus will get millions in salary/pay out and leave the area (maybe that is the silver lining)
    3. The “bottom line” is the “bottom line.”
    4. HCA has a history of overworking their people (all their people)(see #3)
    5. For profits do not have to “give back” to the community (charity care)
    6. For profit hospitals charge more than not for profit hospitals per Wikipedia, “For-profit hospitals, sometimes referred to as alternatively investor-owned hospitals, are investor-owned chains of hospitals. Many of the For-profit hospitals are located in Europe and North America, with many of them established particularly in the United States during the late twentieth century. In contrast to the traditional and more common non-profit hospitals, they attempt to garner a profit for their shareholders. The highest charging hospitals in the US are for profit, according to a study published in the journal Health Affairs in 2015.”
    7. MH Board unanimously approved – Do they truly represent the community. Are MH Board members not selected then voted in by other MH Board members? Where is the community voice and representation?

    1. luther blissett March 23, 2018

      Ron Paulus should be chased out of the area by a pack of dogs.

      Let’s archive this before it’s deleted:

      “Not-for-profit organizations take care of patients regardless of their ability to pay. The Ladies of the Flower Mission and the Sisters of Mercy who established our founding hospitals, Memorial Mission Hospital and St. Joseph’s Hospital, believed passionately in this concept. This means that any excess of revenue over cost is returned to the organization rather than paid to shareholders, as is the case with for-profit hospitals. By returning these dollars, we are able to reinvest them in staff, programs, equipment and buildings, which not only results in better care close to home, but also creates new jobs in our community.”


  6. Pam Messe March 22, 2018

    I am surprised that our area communities are not more upset over this. For profit hospitals especially one with HCA’s reputation don’t have to accept patients. Mission already has a Monopoly. Now greed will be their driving force and mandate.

  7. Anonymous March 22, 2018

    Hard to welcome this news as a positive when HCA has been a part of two huge fraud lawsuits … one that cost HCA $2 billion – largest fraud lawsuit in US history.

    In addition, apparently Ron Paulus was celebrating pretty hard last night at his home. A catered party by Curate and wine delivered to the tune of $16000.

  8. NFB March 22, 2018

    Oh goody. “Health care” by balance sheet. What could possibly go wrong?

  9. $$$hungry March 22, 2018

    these people are criminals, can’t wait for them to come to avl and start competing with all the other criminals running this town

  10. Dave March 22, 2018

    HCA … what a fine, reputable organization. The love child of former Republican Senate Majority Leader Bill Frist.
    “In July 2005, U.S. Senator Bill First sold all of his HCA shares two weeks before disappointing earnings sent the stock on a 9-point plunge. Frist claimed that he sold his shares to avoid the appearance of a conflict of interest if he ran for president. Other executives sold their stock at the same time. Shareholders sued HCA and alleged that the company made false claims about its profits to drive up the price, which then fell when the company reported disappointing financial results. Eleven of HCA’s senior officers were sued for accounting fraud and insider trading. HCA settled the lawsuit in August 2007, agreeing to pay $20 million to the shareholders.”

  11. Find Grace In Healing March 22, 2018

    For profit medicine is the root of all American health care issues. Doctors, nurses, specialists, researchers, etc., should all be paid handsomely – for they do the work of angels – but it stops there. Capitalism has no place in healthcare. I once was proud of Mission, but this is a shameful and greedy move that will create abscess rather than benefit our community.

  12. John James March 21, 2018

    I bet all the board members of the community hospitals who voted to join Mission to be part of a wnc – based nonprofit system feel betrayed. Paulus has found a way to sell off the community’s assets to a for profit that answers to Wall Street not the people of WNC.

  13. luther blissett March 21, 2018

    “If the acquisition is approved, Mission Health, which operates as a not-for-profit, would move to a for-profit entity.”

    So how exactly does that happen under NC law? Ron Paulus signs the deal, takes a large payoff, and Mission then becomes the property of a bunch of venture capital funds?

    The question was always whether years of acquiring everything in the area was designed to fend off a hostile takeover or make itself attractive to a corporate suitor.


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