FAQs

Mission Health is exploring the possibility of joining HCA Healthcare. Learn more about this decision and the benefits it holds for our people, patients and communities.

Top 10 FAQs

Mission Health’s Board continually explores what is best for Mission Health and the health and well-being of the residents of western North Carolina. In that context, the Board has reviewed whether remaining independent is in the best interests of the community every year or so for the past eight years. Government, businesses and payors are demanding that healthcare providers assume more risk and continually reduce costs.  As a result, healthcare mergers and acquisitions are taking place across our country and our state at an unprecedented pace and that pace is likely to accelerate even further.

The Mission 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, knew that it was essential that we act from a position of strength to shape our desired future. Given the inevitability of consolidation, we wanted it to be our choice long before we are forced to make one. After a careful and thorough search, the Board is assured that HCA Healthcare is right for our team, patients and communities. It’s from this position of strength that we are able to ensure that our selected choice is as invested as we are in our mission, people, patients, providers and communities.

HCA Healthcare intends to grow here in western North Carolina by investing in increased access to care, expansion of existing and new services and supporting our communities with the creation of a very significant foundation, which would be administered by people in our communities for the people who live in our communities. With tens of millions of dollars to invest annually, the foundation’s potential is life-changing.  The Board was also impressed with HCA Healthcare’s nine consecutive years of being designated as one of the “World’s Most Ethical Companies” by the global leader in advancing the standards of ethical business practices, the Ethisphere Institute.

The decision was most certainly shared with the community on March 21, 2018.  As the community governing body, the Board has both the legal and fiduciary responsibility to thoroughly deliberate, vet and approve courses of action they believe to be in the best interest of the communities Mission Health serves.  The Board adhered to these responsibilities when considering, approving and then communicating its decision to explore joining HCA Healthcare.

It’s important to note that each Board member is also a community member, volunteering his or her time because they care deeply about ensuring access to high quality care for the people of western North Carolina for generations to come. It’s their commitment to their community that governs all of their decision-making.

HCA Healthcare has a proven track-record of making meaningful investments in its communities – not just for its healthcare operations but beyond.  A key component of this agreement, should it move forward, is the creation of a very substantial foundation.  While the final details still need to be worked out, its assets will be focused on the people who live in our communities.  With the potential of tens of millions of dollars or more available every year for improving the health of the residents of western North Carolina and beyond, the possibilities of this new foundation are nothing short of transformational.  In addition, HCA Healthcare will pay local and state property, sales, use and other taxes that will support our local community governments.

HCA Healthcare has unique scale benefits and broader capabilities that are difficult, if not impossible, to match.  Understanding the unique, special needs of our patients, particularly those in remote and rural areas, we look forward to the possibility of expanding access and accelerating improvements while gaining efficiencies.

A key component of this agreement, should it move forward, is the creation of a very substantial foundation.  While the final details still need to be worked out, its assets will be focused on the people who live in our communities.  With the potential of tens of millions of dollars or more available every year to improve the health of the residents of western North Carolina and beyond, the possibilities of this new foundation are nothing short of transformational.  That’s great news for our patients and communities!

HCA Healthcare intends to use Mission Health as its platform for growth and expansion across the region.  They plan to invest and grow here so, importantly, we do expect new jobs and new opportunities to be created – particularly for clinical staff.  Fundamental to HCA Healthcare’s philosophy is to provide the support and resources needed for local leaders, service providers and clinicians to best meet the needs of their patients, with the same high-quality care they have come to expect and deserve.

Our goal in pursuing joining HCA Healthcare is to be an even stronger organization going forward than we would be alone.  While some positions will likely change or be eliminated over time due to changes in market demand as they have been for years, we do not anticipate significant changes beyond what we typically experience or that otherwise would be required as we evolved and expanded our organization alone, without an HCA Healthcare relationship.  Additionally, HCA Healthcare plans to invest and grow here so, importantly, we do expect new jobs and new opportunities to be created – particularly for clinical staff.

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.  Mission joining HCA Healthcare would also be HCA Healthcare’s entry into North Carolina allowing for additional growth opportunities.

HCA Healthcare was founded 50 years ago by two physicians in Nashville, Tennessee.  It is one of the nation’s most respected healthcare providers, operating 177 locally managed hospitals and 119 surgery centers located in 20 states and in the United Kingdom.  HCA Healthcare does not presently have any operations in North Carolina.  HCA Healthcare is committed to the care and improvement of human life and shares our deeply held commitment to our people, patients and communities.  HCA Healthcare offers hundreds of clinical trials each year as part of its commitment to advancing medicine and, for the past nine years, HCA Healthcare has been named one of the “World’s Most Ethical Companies.” You can learn more about HCA Healthcare here.

As Mission Health moves through this process, we pledge to be as transparent as possible and share information in a timely manner. We also have created a website dedicated to keeping our patients, team members and communities informed. We invite you to visit www.MissionHealthForward.org regularly.

Mission Health FAQs

While it simply isn’t possible to answer this question with 100% certainty because it involves other parties (namely HCA Healthcare and numerous insurance companies), there is no reason to believe that there will be any change to Mission Health’s in-network status with any insurance company as a result of the transaction.

Nothing is changing other than the owner of the health system and everything else remains the same under all insurance contracts, until they reach the termination date.  As a legal matter, the insurance companies will need to agree to transfer the contract to the new owner, but that is a very simple, administrative matter that routinely occurs and shouldn’t create any difficulties.

Yes, all Mission Health entities and provider groups will continue to accept Medicare.

We don’t understand this question.  If it relates to the contemplated transaction with HCA Healthcare, all proceeds from that transaction will go into the new Foundation that is separate and distinct from HCA Healthcare, which will have no control or influence over that Foundation.  Rather, that Foundation will be governed by a Board established by the current Mission Health Board and those funds will be used to support to the current mission of Mission Health: to improve the health of the citizens of western North Carolina and the surrounding region.

Mission Health will always handle its financial transactions, including its bond transactions, in good faith and in accordance with the obligations disclosed clearly to investors in the underlying documents for any bond. Please see the Mission Health System voluntary disclosure that has been posted to the EMMA website maintained by the Municipal Securities Rulemaking Board. https://missionhealthforward.org/EMMA-Notice-Mission-Redemption-Provision.pdf

 

It is still too early in the process to have worked through these types of details.  We’ll know more as our conversations continue over the next several months. As we have new updates and information, it will be posted to MissionHealthForward.org.

Because of Mission Health’s extraordinary track record of delivering high quality, compassionate  care, its national recognition and superb financial performance and associated bond rating, Mission Health was very fortunate to have numerous choices for a partnership.  After thoughtfully and carefully considering the options, the Mission Health Board determined unanimously that HCA Healthcare is the best choice for our team members, our patients and the communities we serve.

Mission Health will be a distinct division within HCA Healthcare.  This means that our system will remain intact with continuity of leadership, services and our existing Mission Health name.

Our top three greatest concerns are just one: the unsustainability of providing healthcare in an environment where the costs of care continue to rise (prices of drugs, medical supplies, wages and benefits, etc.), but payors and the government are unwilling to share their portion of the responsibility and instead continually asking health systems to do more with less.  While the environment is not going to change, our potential transaction with HCA Healthcare will change our ability to manage in that environment.  Mission Health will be far better positioned to withstand these external factors as part of HCA Healthcare than on our own.

At this time, our focus is on delivering world class healthcare to our patients and on our proposed transaction with HCA Healthcare.

As you know, being named a nationwide Top 15 Health System in five of the past six years is an extraordinary feat which represents the incredible dedication, skill, compassion and commitment to excellence of the entire Mission Health team.  But no organization can rest on its laurels; rather, it must continue to evolve, change and adapt to rapidly changing market conditions.  Mission’s goal in potentially joining HCA Healthcare is to become an even stronger organization going forward than we would be alone.

Mission Health and HCA Healthcare make a good match given our rankings and the fact that 106 of HCA Healthcare’s hospitals are on The Joint Commission’s list of Top Performers on Key Quality and 10 of their hospitals rank among the eight percent of hospitals nationwide that are Magnet designated for providing the highest quality of patient care, nursing excellence and innovations in professional nursing practice.  Although we are in process, Mission Health does not yet have a hospital that has achieved this designation.

HCA Healthcare brings significant capabilities in clinical trials, research, predictive modeling and analytics and more that augment the excellent capabilities that Mission Health has now.  We expect that patients, team members and our community will all benefit from the planned transaction.

Mission Health’s Board and management are always exploring what is best for Mission Health and most importantly, the health and wellbeing of the residents of western North Carolina and have had discussions with many different health systems within North Carolina and beyond.  That is the key fiduciary duty of the local community members who comprise the Mission Health Board of Directors and who govern Mission Health; it is a continuous process.

The primary criteria for ultimately selecting a partner were: the ability to build upon and extend our core mission: to improve the health of the people of western North Carolina and the surrounding region, which potential partner would bring the most benefit to Mission Health and western North Carolina and build upon our century-long history of high quality, compassionate care.  After a careful and thorough search, Mission Health’s Board is assured that HCA Healthcare is right for our team, patients and communities. Importantly, HCA Healthcare does not currently have any operations in North Carolina, which means they plan to use Mission Health as a platform for expansion and there are no current concerns of market concentration or overlap.

You are correct that Mission Health will be a new division within HCA Healthcare.  What that means is that certain local infrastructure (such as management, key support departments and so on) will remain local rather than being fully centralized.  The Mission Health division will serve as a platform for growth.  This also means that our system will have continuity of existing leadership, services and name.  Additional details will be determined as Mission Health and HCA Healthcare continue our discussions toward a definitive agreement.

If the transaction moves to completion, HCA Healthcare (HCA) will be responsible for the remaining budget for the Mission Hospital for Advanced Medicine.  Like the Mission Health Board, HCA management understands the critical importance of that new facility for everyone in western North Carolina, and they have committed to completing it.

There are far more similarities than there are differences.  Fundamentally, all hospitals are obligated to meet the same federal and state requirements and are held to the same quality and patient safety standards.  One obvious difference is that for-profit organizations pay taxes, which helps benefit communities.  Here is a quick comparison.

Mission Health does not have shareholders and no one – not the Board, nor CEO nor management – stands to personally benefit from this transaction. The people who will benefit the most should this transaction move forward, are our communities and patients. Becoming part of HCA ensures that Mission Health is here for the long-term and able to continue – and enhance – our tradition of providing high quality care. This is a win for our patients.

HCA provides scale and resources that Mission Health doesn’t have, helping us to access new tools and technologies, which is a win for our team. Finally, the creation of a substantial new foundation as part of the contemplated transaction that could invest tens of millions of dollars annually will enable us to support the underserved and address the root causes of many health problems in ways and with depth that would have been completely impossible.

As a result of the contemplated transaction, Mission Health would become part of the HCA Healthcare family.

Importantly, Mission Health, and our facilities, will remain in western North Carolina—providing the same world-class care and services, with the same people and the same name as it has for the past 133 years.  Together, Mission Health and HCA Healthcare will bring the strength of Mission Health’s clinical excellence with HCA Healthcare’s commitment to investing in western North Carolina through improved access to care and the creation of a new foundation that would invest tens of millions of dollars each year to improve the health of our 18-county region, including a focus on the social determinants of health.

We have posted a voluntary disclosure on EMMA website (MSRB.org – Municipal Securities Rule Making Board) for current bondholders. To learn more please click here.  We cannot speculate on why markets react the way they do.

This proposed transaction is about preserving and expanding care. Importantly, although we are still early in the negotiation process and haven’t completed due diligence, HCA Healthcare has made initial commitments to ensuring that our capital projects in flight continue, including Angel Medical Center and the Mission Hospital for Advanced Medicine. If HCA Healthcare were to acquire Mission Health it would be responsible for constructing a new hospital facility in Franklin. Until that time, if ever, Mission Health remains responsible for the new facility. Our patients in Franklin can look forward to the same high-quality care, delivered by their trusted caregivers, that they deserve and have come to expect.

Healthcare costs aren’t driven by the ownership of a facility but rather by the input costs incurred to provide care. Therefore, we don’t expect that patients will see any significant changes related to the transaction. However, one of the benefits of joining HCA Healthcare will be increased efficiencies, so we look forward to the expanding access and accelerating improvements.

Healthcare costs aren’t driven by the ownership of a facility but rather by the input costs incurred to provide care. Therefore, we don’t expect that patients will see any significant changes related to the transaction. However, one of the benefits of joining HCA Healthcare will be increased efficiencies, so we look forward to the expanding access and accelerating improvements.

No, not anything more specific or different than any other Mission Health entity.  Mission Hospital – McDowell is an important member of the Mission Health system.  As for all of Mission Health, we believe this is the right choice for our communities, patients and team members and truly transformational for all of western North Carolina.  HCA is excited about the brand-new Mission Hospital – McDowell and looks forward to serving the community for a very long time.

McDowell patients can look forward to the same high-quality care, delivered by their trusted caregivers that they deserve and have come to expect.  But in addition, the remarkable new Foundation that will be created to improve the health of the people of western North Carolina and the surrounding region will be a game changer for our community’s health, including but not limited to the McDowell community.

Thank you for your question about how becoming a for-profit might impact quality of care and treatment of the uninsured.  The proposed transaction is about preserving and expanding services and there is no plan to discontinue behavioral health services. 

Joining HCA Healthcare would not change how Mission approaches patient care. All hospitals are required to meet many of the same federal and state requirements and are held to the same quality and patient safety standards.  Both for-profit and non-profit hospitals provide charity care.  A key difference is that as a for-profit organization, Mission would pay taxes, which would benefit our communities.  Here is a quick comparison of for-profit and not-for-profit hospitals:  https://missionhealthforward.org/wp-content/uploads/2018/03/Mission-Health_comparison-chart_r4-1.pdf

Further, you might be interested to know that HCA Healthcare is the second largest provider of Behavioral Health services in the nation.  Even more, the letter of intent specifies that HCA Healthcare will continue Mission’s in-flight capital projects, including a new Behavioral Health hospital.  Simply put, HCA Healthcare has a significant commitment to patients requiring Behavioral Health support.  Also, you might be interested in this study by the Harvard School of Public Health that determined that switching from non-profit to for-profit status appears to boost hospitals’ financial health but does not appear to lower the quality of care they provide or reduce the proportion of poor or minority patients receiving care.  Here’s the link: https://jamanetwork.com/journals/jama/fullarticle/1917437.

We anticipate that the due diligence process will take 90-120 days to complete. If we confirm in this next discovery phase that joining HCA Healthcare holds the great promise and potential that we believe it does and definitive agreements are signed, that will trigger a 90-day regulatory review period. If regulatory requirements are met, Mission Health would then become a member of the HCA Healthcare family sometime later this calendar year.

We have signed a letter of intent to explore a relationship with HCA. It is far too early to have definitive answers to many questions. That said, if HCA Healthcare were to acquire Mission Health, subject to due diligence, it would acquire the entirety of the health system, including Mission Hospital, Angel Medical Center and other Mission Health member institutions. Mission would not “remain autonomous”, it would be part of HCA Healthcare as would Angel Medical Center.

HCA Healthcare has a long, proven history of investing into the communities it serves – from expanding access to urgent and primary care to enhancing specialty services. We do know HCA is committed to investing and helping move healthcare forward in each of our local communities by helping improve access and maintain quality and clinical outcomes. We’ll know more as our conversations continue over the next several months and due diligence is performed as described in the letter of intent.

The North Carolina Attorney General’s Office is required to review and approve the proposed transaction. With respect to the FTC or the US Department of Justice, it’s important to note that HCA Healthcare does not currently operate in North Carolina.  While we can’t presume to speak for regulators, we do not anticipate any competitive concerns.

As a result of the contemplated transaction, Mission Health would become part of the HCA Healthcare family.

Importantly, Mission Health, and our facilities, will remain in western North Carolina—providing the same world-class care and services, with the same people and the same name as it has for the past 133 years.  Together, Mission Health and HCA Healthcare will bring the strength of Mission Health’s clinical excellence with HCA Healthcare’s commitment to investing in western North Carolina through improved access to care and the creation of a new foundation that would invest tens of millions of dollars each year to improve the health of our 18-county region, including a focus on the social determinants of health.

We are still early in the process, but we are excited about the possibility of joining HCA Healthcare.  Any transaction remains subject to due diligence and eventual approval by the Attorney General.  Given the promise and potential we believe this holds for western North Carolinians, we are hopeful this transaction will proceed smoothly and receive the required regulatory approvals.

The decision was most certainly shared with the community on March 21, 2018.  As the community governing body, the Board has both the legal and fiduciary responsibility to thoroughly deliberate, vet and approve courses of action they believe to be in the best interest of the communities Mission Health serves.  The Board adhered to these responsibilities when considering, approving and then communicating its decision to explore joining HCA Healthcare.

It’s important to note that each Board member is also a community member, volunteering his or her time because they care deeply about ensuring access to high quality care for the people of western North Carolina for generations to come. It’s their commitment to their community that governs all of their decision-making.

Transylvania Regional is our major facility in the area and it would benefit, like our other facilities, from this proposed transaction.  Moreover, although we are still early in the negotiation process, HCA Healthcare has made initial commitments to ensuring that our capital projects in flight continue. Our patients in Transylvania, Polk and Henderson counties can look forward to the same high-quality care, delivered by their trusted caregivers, that they deserve and have come to expect.

Mission Health’s Board continually explores what is best for Mission Health and the health and well-being of the residents of western North Carolina. In that context, the Board has reviewed whether remaining independent is in the best interests of the community every year or so for the past eight years. In light of relentless pressure from payors, government, businesses and others to reduce healthcare costs, mergers and transactions have been taking place at an unprecedented pace within the healthcare industry and that pace is likely to accelerate even further. Given the inevitability of eventual consolidation, the Mission Health Board wanted it to be our choice from a position of strength long before we are forced to make one. After a careful and thorough search, the Board is assured that HCA Healthcare is right for our team, patients and communities. It’s from this position of strength that we are able to ensure that our selected choice is as invested as we are in our mission, people, patients, providers and communities.

Yes, as the result of the signing of the Letter of Intent, Mission Health and HCA Healthcare have begun the due diligence and definitive negotiation phase of process.

HCA Healthcare FAQs

The Columbia challenges are from more than twenty years ago and before the 1997 return of HCA Healthcare’s founder as Chairman and CEO.    HCA Healthcare is a different company now and celebrates nine consecutive years as one of the “World’s Most Ethical Companies” as designated by Ethisphere, the global leader in advancing the standards of ethical business practices.

While HCA has a process for determining appropriate charges that is based on the cost of providing care in a particular community, the broader industry issue of hospital charges and patient billing can be confusing.  What is important to remember is that the amount patients actually pay for hospital services has more to do with the type of insurance coverage they have than the amounts listed on a hospital’s chargemaster.  Government programs like Medicare and Medicaid determine how much they reimburse hospitals, and commercial insurance plans negotiate rates.

Uninsured patients are eligible for free care through HCA’s generous charity care program or receive uninsured discounts, which are similar to those a commercial insurance plan receives.

The Columbia challenges are from more than twenty years ago and before the 1997 return of HCA Healthcare’s founder as Chairman and CEO.    HCA Healthcare is a different company now and celebrates nine consecutive years as one of the “World’s Most Ethical Companies” as designated by Ethisphere, the global leader in advancing the standards of ethical business practices.

It is too soon to know how Mission Health and HCA Healthcare will grow in our region.

While HCA Healthcare will always evaluate opportunities to expand their presence within communities they serve, our focus now is to work together on the Mission Health partnership and to finalize our proposed transaction by year end.

HCA Healthcare does not currently have a presence in western North Carolina. So, while it is too soon to have answers to every possible question, there is nothing that we are aware of at this time that would impact Mission’s EMS services or fixed wing support.

HCA Healthcare has numerous examples of population health activities, care coordination platforms and markets focused on primary care.  Its practices and 1000+ primary care physicians are providers in Medicare and Commercial accountable care organizations, comprehensive primary care plus practices, Medicare Advantage and shared savings programs, and clinically integrated networks.

Non-Profit vs. For-Profit FAQs

Tax benefits will apply anywhere that Mission Health owns property or provides taxable services. We don’t yet have an estimate of the potential impact locally.

Joining HCA Healthcare would not change how Mission approaches patient care or treatment of the uninsured in any way, and Mission’s charity care would absolutely continue under HCA Healthcare.  HCA Healthcare has committed to continuing a generous charity care policy, and elimination of charity care programs is inconsistent with their mission and the Hippocratic Oath sworn by its founding physicians.

Also, whether a hospital operates as a non-profit or a for-profit, its legal requirements to serve the poor and uninsured are essentially the same.  Federal law protects patients who are in need of emergent care, and it is illegal to require up-front payments for that care.  Regardless of status, all hospitals are obligated to meet the same federal and state requirements and are held to the same quality and patient safety standards.

Additionally, a report by Harvard School of Public Health confirmed that not-for-profit hospitals and health systems switching to for-profit status maintained their level of care for poor patients or at-risk populations.

 

Thank you for your question about whether Mission Health will become a for-profit company if it joins HCA Healthcare. The answer is yes. However, there are far more similarities than there are differences, and joining HCA Healthcare would not change how Mission approaches patient care.  Fundamentally, all hospitals are obligated to meet the same federal and state requirements and are held to the same quality and patient safety standards.  Both for-profit and non-profit hospitals provide charity care.  A key difference is that as a for-profit organization, Mission would pay taxes, which would benefit our communities.  Click here for a quick comparison of for-profit and not-for-profit hospitals.

Foundation FAQs

Mission has no ownership of the Highlands Cashiers Foundation and has never had any ownership of that Foundation.  Rather, it is an independent, tax-exempt foundation supporting Highlands Cashiers Hospital. As such, it is distinct from and not part of the HCA Healthcare and Mission Health relationship currently in due diligence.  That money has always been, and will always remain in that Foundation supporting that Foundation’s purposes.

Thank you for your excellent questions.  First, none of the existing Foundations within the Mission Health system are part of the contemplated transaction with HCA Healthcare.  Those foundations will remain intact.

Second, the newly formed foundation contemplated as part of this transaction will receive all of the proceeds from the transaction.  Those proceeds will be determined by the ultimate purchase price paid, and any remaining balances within Mission Health after retiring all outstanding debt, payables and adjustments for working capital.  It is those total proceeds that will be used to improve the health of the people in western North Carolina and the surrounding region.  While many details remain to be determined, including the specific structure of the newly created foundation, a rule of thumb might be that 5% of foundations assets are spent yearly in support of its mission.

We have created this website to be dedicated to providing you information and updates about this transaction. It contains all public available information at this time. Given the Letter of Intent begins a further evaluation of a potential relationship, it’s just too early to speculate what HCA’s expanded access to care may entail for western North Carolina. There is this LOI period, followed by a due diligence phase and then a regulatory approval phase. So still a long way to go.

 

Yes, there is an enforcement role that is part of the new Foundation that will be created to oversee and manage the proceeds from the contemplated transaction with HCA Healthcare.  HCA Healthcare will be making significant contractual commitments to operate in certain ways and with certain obligations.  The Foundation, in addition to its transformational role in improving the health of the people of western North Carolina and the surrounding region, will also be the entity charged with enforcing those contractual obligations, should there ever be a need to do so.

More generally, joining HCA Healthcare would not change how Mission approaches patient care. All hospitals are required to meet many of the same federal and state requirements and are held to the same quality and patient safety standards.  Both for-profit and non-profit hospitals provide charity care.  Here is a quick comparison of for-profit and not-for-profit hospitals: https://missionhealthforward.org/wp-content/uploads/2018/03/Mission-Health_comparison_chart_r4-1.pdf

Also of interest, is a study by the Harvard School of Public Health that determined that switching from non-profit to for-profit status appears to boost hospitals’ financial health but does not appear to lower the quality of care they provide or reduce the proportion of poor or minority patients receiving care. Here’s the link: https://jamanetwork.com/journals/jama/fullarticle/1917437.

The net proceeds from the sale of Mission Health will go into the foundation, supporting substantial annual investments – expected to be many tens of millions of dollars or more every single year –for improving the health of the residents of western North Carolina.  The potential impact of the foundation will be transformational for our region.

The foundation will be established and a governing board created by the current Mission Health Board of Directors. It will not be controlled or influenced by HCA Healthcare; rather, it will be focused on the current mission of Mission Health: to improve the health of the citizens of western North Carolina and the surrounding region.

We have not specified any specific amount of money that the Mission Foundation will receive, so can’t comment on your stated number.  Under the contemplated transaction, Mission Health will become part of HCA Healthcare.  Said another way, HCA Healthcare is buying all of Mission Health (subject to due diligence).  In return, Mission Health will create a very large Foundation focused on the current mission of Mission Health: to improve the health of the citizens of western North Carolina and the surrounding region.  The newly formed Foundation will also have an enforcement role ensuring that HCA Healthcare honors the significant contractual commitments it will make to operate in certain ways and with certain obligations.  Included in those obligations will be certain limitations on program and service changes as well as on the potential sale of any or all of Mission Health in the future.

During the due diligence period the grants staff in the Department of Philanthropy are identifying potential partners on currently grant-funded programs where, if the partnership with HCA is finalized, grant awards could be transitioned to support and continue Mission Health’s programmatic activities and deliverables required by the funder in the grant agreement.  Also, if the transaction is ultimately consummated, Mission Health will create a very large Foundation focused on the current mission of Mission Health: to improve the health of the citizens of western North Carolina and the surrounding region.  That new Foundation therefore would have similar interests to the current grant work underway.

Employment FAQS

We certainly understand and share your concern about the potential impact on student loans. While we are sensitive to any potentially impacted individual’s concern, please bear in mind that this is a federal program and not a benefit that is provided by Mission.  The program itself has only existed since 2007, with an enhancement by the Obama administration in 2010.

Currently, the program is dramatically under-funded which puts its long-term sustainability in doubt for all participants, whether working for a non-profit or not. Further, there have been numerous federal discussions about eliminating the program in its entirety and it is extraordinarily complex even for those who believe that they are in it, to actually determine whether they qualify and when – if ever – they will benefit from the program. See for example: Panicked Borrowers, and the Education Department’s Unsettling Silence , A Student Loan Fix for a Teacher, and Many Other Public Servants or Who Is a Public Servant? Borrowers Have a Lot Riding on the Answer.

 

All participants are expected to submit an employer attestation each year they participate in the program (see:https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service); at Mission Health, there are less than seventy such individuals who have done so but there are just over two hundred who currently perceive that they are in the program. All that said, we share the concern about any potential impact on student loans, and we are investigating whether there are any realistic options to mitigate or eliminate those concerns.  Unfortunately, it is too early to have any definitive guidance at this time, but we will communicate more as any options become clearer.

Thank you for your question about Mission’s EMS services. Importantly, Mission Health is not going anywhere. This proposed transaction is about preserving and expanding healthcare for the communities of western North Carolina.  While it is too soon to have answers to every possible question, there is nothing that we know of at this time that would impacts Mission’s EMS services.

Although Mission Health has signed a letter of intent with HCA Healthcare, we do not have the answers to every possible question.  However, as the letter of intent is currently structured, subject to due diligence, all of Mission Health, including CarePartners and Eckerd Living Center would become part of HCA Healthcare, operating under the current name.

While we are still early in the process, it is HCA Healthcare’s desire to retain current management. Current management is one of the many reasons that HCA Healthcare is interested in Mission Health. It is anticipated that Mission Health would remain as an independent division of HCA Healthcare with current management operating the division and overseen by HCA Healthcare. As is true with every topic, all decisions are subject to due diligence on both sides and the choice of individuals in management.

At this point in the process, we don’t have answers to your specific question. As part of this next phase we will be working out these types of details. What we can tell you today is that we working to minimize the impact of jobs losses in the areas where consolidation is expected and that we don’t expect reductions to be any more than we have experienced previously or that would be required as Mission evolved and expanded our organization alone, without an HCA Healthcare relationship.

Our goal in pursuing joining HCA Healthcare is to be an even stronger organization going forward than we would be alone.  While some positions will likely change or be eliminated over time due to changes in market demand as they have been for years, we do not anticipate significant changes, but beyond what we typically experience or that would be required as we evolved and expanded our organization alone, without an HCA Healthcare relationship.  Additionally, HCA Healthcare plans to invest and grow here so, importantly, we do expect new jobs and new opportunities to be created – particularly for clinical staff.

Effectively yes.  The letter of intent, subject to due diligence, envisions a 3-year transition from Mission Medical Associates to HCA Healthcare’s employed physician group.  We are just now entering the due diligence phase to be followed by a regulatory approval phase.  So still a long way to go. We invite you to keep informed on the website.

While we understand that everyone has their own perceptions, we do not agree with the characterization of “prior to Mission taking over” and subsequent to Mission enabling the hospital to remain viable and dramatically improving both clinical and operating performance. Service offerings are driven by what can be done safely and effectively in any given community. In view of the fact that the community isn’t changing with this contemplated transaction, it would be unlikely that services would change significantly.  Mission is very proud of the work we have done in collaboration with the Highlands Cashiers Board and the community.

 

With regard to your questions about potential future changes on the Highlands Cashiers campus what we can say today is that HCA has a long, proven history of investing in the communities it serves – from expanding access to urgent and primary care to enhancing specialty services; HCA is committed to investing and helping move healthcare forward in each of our local communities by helping improve access and maintain quality and clinical outcomes.  We’ve only just entered the LOI and will begin having these more specific conversations about how HCA would move forward with respect to current or planned future projects within each local community.  We’ll know more as our initial conversations continue over the next several months.

The StandOut program will be retained for at least two years following the close of the proposed transaction.  As with any organization, our culture has evolved over time and will continue to evolve, whether or not Mission Health ultimately joins HCA Healthcare.  What won’t change is our commitment to our community, team members and core values.

Thank you for asking this question! It seems that this incredible opportunity has been somewhat lost in the larger news, understandably. Mission Health and HCA Healthcare intend to create a healthcare innovation fund that will be based in Asheville and dedicated to fostering innovations, companies and jobs dedicated to improving health. Mission and HCA Healthcare will each contribute $25 million to the fund.  The innovation fund is in addition to the establishment of a large new foundation that would provide tens of millions of dollars in annual investments dedicated to improving the health and wellbeing of western North Carolina.

It is still far too early in the process to have worked through this level of detail.  We’ll know more as our conversations continue over the next several months. As we have new updates and information, it will be posted to MissionHealthForward.org.

HCA Healthcare has a wide variety of risk-bearing experiments in different markets, including one-sided and two-sided Accountable Care Organization models and more.  While it is still too early in the process to have worked through these types of details, we know that they have interest in our success in both entities, and we’ll know more as our conversations continue over the next several months. As we have new updates and information, it will be posted to MissionHealthForward.org.

It is still far too early in the process to have worked through these types of details.  What we do know is that HCA Healthcare has made a commitment to transitioning team members that it will occur on a comparable basis.  It would be impossible for every benefit to be identical, but on average, we expect things to be comparable.  We’ll know more as our conversations continue over the next several months.  As we have new updates and information, it will be posted to MissionHealthForward.org.

 

HCA Healthcare has agreed to assume all existing contracts held by Mission Health, including our important contracts with MAHEC.  They are aware of the very important role that MAHEC provides within Mission and across western North Carolina, and are eager to learn more about potential opportunities. As we have new updates and information, it will be posted to MissionHealthForward.org.

We don’t expect any changes for private practice primary care physicians.  In general, although HCA Healthcare has been expanding its employed physician group in recent years as has Mission Health and most every health system nationwide, the overwhelming majority of physicians associated with HCA are private practice physicians.

HCA Healthcare has agreed to assume all existing contracts held by Mission Health, including our important PSA contracts.  In general, we will continue our routine work schedule.

 

Mission Health will always operate in accordance with the terms and conditions of its existing contracts. As we have new updates and information, it will be posted to MissionHealthForward.org.

Although we do not have specific information yet, we do know that generally HCA Healthcare has benefits that are very comparable to ours and any retirement contributions you have made are and will be safe.

While it is still too early in the process to have worked through these types of details, as part of this next phase, we will be working out these types of details and will make this information available to employees at the appropriate time.

What we do know is that HCA Healthcare has made a commitment to transferring team members that it will occur on a comparable basis.  It would be impossible for every benefit to be identical, but on average, we expect things to be comparable.  We’ll know more as our conversations continue over the next several months.

As you know, retention incentives are used commonly across all industries during potential transactions to ensure the successful completion of a transaction for the benefit of the organization and those it serves. In this case, any such retention incentives would be approved by the Mission Health System board and be targeted to retain employees at risk of leaving who are essential to completing the proposed transaction successfully.

As part of this next phase we will be working out these types of details. Any retention program would target employees at all levels of the organization who meet these criteria, with at most a minority of any retention pool directed toward senior executives.  The Mission Health CEO has been awarded no HCA retention incentive.

Although everyone will have to undergo a repeat drug test and a few other administrative processes we don’t currently expect that clinical (or other) staff will need to reapply for their positions.  If that changes we will communicate with all impacted individuals and will update the website appropriately.

Thank you for reaching out with your question. As we move through this process, we pledge to be as transparent as possible.  While we have few details to share at this preliminary stage, we are committed to keeping you updated and answering any questions for which we have the answers.  We’ll know more as our initial conversations continue over the next several months, and we will keep you informed of any new developments. We invite to keep visiting MissionHealthForward.org regular to learn the latest developments. As we have new updates and information then they will be posted on the site.

Although we do not have every detail yet, we do know that generally HCA Healthcare offers education benefits that are very comparable to ours.  It goes without saying that it would be impossible for every benefit to be identical, but on average, we expect things to be quite similar.  We’ll know more as our conversations continue over the next several months. As we have new updates and information, all impacted individuals will receive updated information.

At this point in the process, we don’t have answers to your specific question.  We do know that HCA Healthcare has work from home policies for many back-office functions.  As part of this next phase of due diligence, we will be working on further understanding these types of details. What we can tell you today is that we are working very hard to minimize the impact of any jobs losses in areas where consolidation is expected and that we don’t expect reductions to be any more than we have experienced previously or that would have been required if Mission continued to operate as a stand-alone organization without an HCA Healthcare relationship.

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