Frequently Asked Questions

After five years of declining healthcare quality, safety, at the hands of HCA, we formed to represent the voices of the community and region and to hold HCA accountable for its harmful practices. We believe that everyone deserves care that is accessible, affordable, safe and of the highest quality possible. HCA has plenty of money to invest in our community's care - they are choosing not to do so. Because of that failure to invest, and indeed HCA’s active divestment in Mission Health, we are advocating to replace HCA with a nonprofit healthcare system that is committed to our WNC region, rather than a system driven by profit for executives, fund managers and shareholders. Regardless of the challenges we face, we have two choices: accept what has become of Mission or advocate for changes needed to restore quality healthcare in our region. The former is not an option.

HCA has had five years to live up to its verbal commitments to invest in WNC and continue Mission’s legacy of patient-centered care. They have not done that, and they have been impervious to repeated calls to adjust their approach to restore best-in-class care across the system. They have offered our community no reason to believe they will change their business model and culture at any point in the future. We believe a non-profit owner that values and will invest in the health of our community is a better option. Regardless of who owns Mission Health, Reclaim Healthcare WNC will hold them accountable to provide quality, safe, accessible, and affordable care.

Mission is a profitable system for HCA and generated the 2nd highest net patient revenue of their 180 plus hospitals in 2024. It will be difficult to convince HCA to sell, and the system will cost more than it did in 2019 when HCA purchased it. We know, however, of non-profit systems that have expressed interest. Our coalition is focusing on creating conditions that can support a sale and will engage in conversations with any organization willing to invest in bringing back quality, safe, accessible and affordable care for our region.

We support the nurses’ efforts to improve working conditions and patient safety. We have attended and spoken at their rallies, and they have attended and spoken at our events. The union, however, is not a member of Reclaim Healthcare WNC and does not participate in our planning.

How does what is happening now compare with what was happening before HCA’s ownership?  What are the key performance indicators that could provide measurable data around some of the concerns being raised? 

HCA does not share all of its data, so this question can be challenging to answer.

However, we do know the following: 

• Patient satisfaction ratings have declined. (Source: Mission Hospital’s Quality Ratings Following HCA’s Acquisition: A Preliminary Report by Mark Hall, Wake Forest University)

• Staffing has declined. (Source: Mission Hospital’s Financial Performance Under HCA: A Preliminary Report by Mark Hall, Wake Forest University)

• Prices have increased. (Source: Mission Hospital’s Financial Performance Under HCA: A Preliminary Report by Mark Hall, Wake Forest University)

Measured by official surveys of patients’ views, HCA Mission now rates near the very bottom, both in North Carolina and nationally. So why do rating groups such as Leapfrog rate HCA highly?

First, there are some indications that hospital reporting practices and data limitations may have skewed some of HCA Mission’s ratings upwards. For example, HCA Mission appears to address quality and safety issues somewhat selectively, rather than striving for excellence across the board. This selective focus is consistent with HCA’s status as a for-profit organization with an obligation to maximize profits for investors, and is consistent with its market position that leaves dissatisfied patients and physicians with limited alternatives. 

Second, to obtain a more expansive view of hospital performance, rating agencies routinely measure the quality of care in ways other than just patients’ experience. A variety of respected sources rate hospitals based in substantial part on objective measures of patient outcomes and hospital processes, such as mortality or infection rates, or taking steps to avoid complications. For several of these key ratings, Mission did not decline initially following HCA’s acquisition. Unlike patient surveys, however, these objective measures have an inherent time lag due to the 2-3 years required to collect relevant data, analyze it, and publish it. Once most of the relevant data began to come from the post-acquisition time frame, Mission’s ratings based on objective measures declined on several fronts, although not as steeply as for patient experience.