Brevard files class-action antitrust lawsuit against Mission, HCA

ASHEVILLE – Nashville-based HCA Healthcare is facing its second antitrust lawsuit out of Western North Carolina in less than a year after the city of Brevard filed in district court June 3, claiming the company holds “monopoly power” in some health care service markets and that the “future of health care competition in Western North Carolina … is at risk.”

Brevard’s lawsuit follows closely on the heels of an antitrust lawsuit filed by several community members in August 2021, making it the second in a year filed against the for-profit health care behemoth, the largest hospital system in the nation.

It proposes class action for “unlawful restraint of trade and monopolization” and seeks damages and relief through a jury trial.

The history of WNC’s antitrust action against HCA Healthcare:

The for-profit HCA Healthcare purchased the Mission Hospital system in 2019, and the lawsuit says it now holds a monopoly market share — 70% or more — in seven counties: Yancey (90.9%), Madison (90%), Buncombe (86.6 %), Mitchell (85.4%), Transylvania (78.7%), McDowell (76.4%) and Macon (74.7%).

Transylvania Regional Hospital is in Brevard, the county’s seat, and is one of five hospitals in WNC owned by HCA Healthcare and in Mission Health regional system.

“Our lawsuit is being brought at a time when providing affordable health care insurance plans for working families and governmental employees, such as firefighters, police, and teachers, and controlling health care costs have been top priorities for the city of Brevard and members of the class, and the business communities they serve,” city of Brevard mayor Maureen Copelof said in a news release disseminated the same day the lawsuit was filed.

She said over the past few years the community has “repeatedly expressed concerns” about what they say are declining health services, difficulty in obtaining those services and high costs.

“Our attempts to address these concerns directly with HCA have been rebuffed,” Copelof said.

HCA and Mission Health spokesperson Nancy Lindell said in a statement that the lawsuit was “beyond disappointing.”

She said Copelof recently had requested a meeting with HCA CEO Sam Hazen.

Lindell called that meeting, which included other community leaders, positive and productive.

“We hoped that meeting would be the beginning of a thoughtful and ongoing dialog about healthcare in the city of Brevard and the broader Transylvania County region,” Lindell said. “In fact, we provided information requested during the meeting and hosted our first community council meeting just this week.”

Lindell noted Copelof in the release did not mention this “apparently long-planned lawsuit, which is frustrating and undermines what we thought were sincere efforts to build open, constructive relationships and lines of communication.”

She said the company will now turn its attention to “vigorously defending” the lawsuit.

HCA is already doing that in another case currently waiting judgment in Raleigh’s North Carolina Business Court.

There, the antitrust suit brought in August and aimed at HCA’s Mission Health flagship operation in Asheville is waiting a decision on whether it can move forward in Buncombe Superior Court.

That case has garnered support from NC Attorney General Josh Stein and state treasurer Dale Folwell: both filed amicus briefs in the case, supporting the plaintiffs, Folwell in his capacity as an individual, not as an elected official.

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Brevard’s lawsuit overlaps in many aspects with the Buncombe lawsuit, both noting variety of care options — notable general acute care hospital services — has dwindled since the 2019 purchase and prices have become problematic for the average patient.

The Brevard case, according to the release, is on how the company through monopoly power is hurting citizens.

“The lawsuit alleges that HCA engaged in a series of predatory tactics designed to impede competition between health care providers,” the release stated. “As a result, Brevard, its citizens, and others throughout western North Carolina have paid inflated prices for lower-quality health care.”

HCA actions, it went on to state, have also harmed Brevard and its community by:

  • Making changes to charity care, impacting some of the most vulnerable members of the community.
  • Performing and billing for unnecessary procedures.
  • Causing the loss of experienced and highly qualified physicians and other health care providers from the HCA system.
  • Reducing the availability of appointments for health care services.

Lindell countered, emphasized the hospitals’ recent successes, specifically those at Transylvania Regional.

“We are proud of our commitment to western North Carolina and the significant investments we have made to serve Brevard and improve patient care,” she said.

According to Lindell, those include:

  • Mission Health’s provision of more than $277 million in charity care and uninsured discounts in 2021.
  • More than $14 million in significant infrastructure projects at Transylvania Regional Hospital, renovating three operating rooms, replacing both the MRI and CT and adding a new helipad.
  • Provision of access to new specialties there, with five recently added primary care providers in the area and renovated the primary care practices.
  • Transylvania Regional’s recognition by Healthgrades for Pulmonary Care Excellence and its top 10% national ranking for overall pulmonary services.

“Health care is absolutely critical to the welfare of our community,” Copelof told the Citizen Times by phone June 6. “To have good healthcare we have to have three things. It has to be affordable, it has to be accessible and it has to be of high quality. That’s what I’m looking for. That’s what I’m trying to ensure that our community has.”

Andrew Jones is Buncombe County government and health care reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or [email protected]. Please help support this type of journalism with a subscription to the Citizen Times.

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