Mission Health, under Nashville-based HCA Healthcare ownership and leadership since February, is looking at growth strategies and currently has more than 700 job openings in its Western North Carolina system of hospitals, two HCA executives said today. (HCA Healthcare acquired Mission for $1.5 billion earlier this year.)
Mission has several new faces in leadership roles following the for-profit HCA Healthcare company’s acquisition of nonprofit Mission in February. Two of those new corporate bosses met with Asheville media representatives Thursday morning at the Mission Health SECU Cancer Center.
Media representatives met Greg Lowe, president of the newly created Asheville-based North Carolina Division, which comprises the recently purchased Mission Health system of six hospitals in Western North Carolina. Media folks also were introduced to Terence van Arkel, the division’s chief financial officer.
Earlier this week, Mission announced that Chad Patrick, chief executive of HCA Healthcare’s Orange Park Medical Center in Florida, has been hired to lead Mission.
The healthcare execs answered a variety of questions. Here’s what stood out to me, in no particular order:
-Thursday’s meeting was held at the Mission Health SECU Cancer Center. The center will see a $4 million investment as part of the building is remodeled to eventually house all cancer specialists under one roof. That sort of “one-stop-shop” offers quality and convenience to patients, Lowe said, and efficiencies of operation for Mission.
-Rural hospitals: Lowe and van Arkel say they see growth opportunities in the rural region of Western North Carolina. They said they can bring economies of scale to bear in WNC. That means they can leverage the power of their size – HCA owns 185 hospitals and more than 1,800 sites of care in 21 states and the United Kingdom – to add efficiencies that help them make more money. Also regarding rural hospitals, Lowe said the size of HCA works to its advantage when recruiting doctors to WNC.
-Angel Medical: The two execs said HCA has confirmed plans to spend $60 million to replace Angel Medical Center in Franklin. Plans are in the works.
-Asheville growth: The HCA Healthcare execs said they’re already seeing a significant growth in demand/usage of services. Why? There are a variety of reasons. First, Mission Health has a stellar reputation built up during decades of not-for-profit ownership. Second, the Western North Carolina region, and Asheville in particular, are both growing. And third, Mission is still enjoying the effects of the removal of rules, known as the Certificate of Public Advantage (COPA), that checked its growth.
-More about the COPA: The N.C. General Assembly repealed the Certificate of Public Advantage law governing Mission Health in 2015. That law, adopted in 1995, was aimed at avoiding an antitrust challenge when two hospitals merged to create Mission. It installed a number of checks on Mission, such as limiting the number of doctors the hospital could hire and restricting its operating margin.
-Buzzwords are “market share”: For a for-profit entity like HCA, a key overall metric is “market share.” Modern Healthcare reported in April 2018 that Mission, a six-hospital, not-for-profit health system based in Asheville, held a 49.5 percent market share across the 11 counties it operates in, according to an analysis by consulting firm Healthcare Management Partners, using the Modern Healthcare Metrics database. That’s compared to a 50.5 percent share divided among its competitors. That was then. Lowe and van Arkel said today that their market share has been growing.
-Reminder: HCA is a publicly traded company beholden to shareholders, and it has a reputation for stringent cost controls.
-Jobs: The two execs noted that Mission Health is hiring. The HCA Healthcare execs overseeing Mission said today they have more than 700 job openings in the Mission system of hospitals. The Mission system across Western North Carolina employs about 12,000 workers.
-Nurses needed: Mission Health’s greatest need on the hiring front: nurses. One of Mission’s execs quipped that “if you’ve got an RN, send ’em our way.
-The big opening: Another issue Lowe and van Arkel are managing is the opening of a massive new hospital in Asheville. It’s called the North Tower at Mission. It’s a 12-story, $400 million state-of-the-art hospital with 220 beds, integrated care areas and an emergency department twice the size of what’s there now. When everybody gets moved into the new building, that will open up space across the existing complex, especially at what’s known as the St. Joseph’s campus of Mission. Lowe and van Arkel said they’ll be juggling all the moving pieces for quite some time.
-Payer mix: Asheville Citizen-Times reporter John Boyle asked van Arkel how HCA is handing the financial difficulties of operating in Western North Carolina, where about 75 percent of Mission Health’s revenue comes from the government through Medicare and Medicaid. Those payments typically don’t cover costs. “We don’t control how we’re paid on 75 percent of our business,” van Arkel emphasized. The company is acutely aware of the situation, and constantly working to address it, he said.
“if you’ve got an RN, send ’em our way.”
OK, where are they gonna live? Affordable housing in Buncombe is all but non-existent, even on an RN salary.
And how about parking? New staff at Mission park at remote lots and are shuttled to work, adding an hour (unpaid) to each work day.