HCA Healthcare
February 01, 2019

SOURCE: Asheville Citizen Times

Ambulances parked outside of Mission Hospital. (Photo: Angeli Wright/awright@citizen-times.com)

Mission Health will continue to provide emergency medical services (EMS) in Madison County after the $1.5 billion buyout deal with HCA Healthcare takes effect. The Madison County Board of Commissioners approved a one-year extension January 29 that will see the Western North Carolina health care giant continue its operation of 24/7 ambulance service crews in Marshall, Mars Hill and Hot Springs.

While past agreements between Mission and Madison County for EMS have seen two-percent annual increases, this deal to extend services through June 2020 will see the county pay the same $1.1 million annual rate to Mission EMS as the 2018-19 deal.

Mandated by merger agreement

North Carolina Attorney General Josh Stein said that a modified merger agreement negotiated by his office mandates that the new HCA entity continue EMS in the rural counties where it currently operates one year after the scheduled January 2019 merger close.

North Carolina Attorney General Josh Stein announces that he does not object to HCA's purchase of Mission Health in a press conference at the Murphy-Oakley Recreation Center on Jan. 16, 2019. (Photo: Angeli Wright/awright@citizen-times.com)

“What HCA is committed to doing is providing full financial support for Madison, Mitchell and Yancey county, where they do the EMS, for one year,” Stein said. “It can go on beyond that, but they’re only committing to one year. That will at least give those counties an opportunity to figure out an alternative if it’s clear that HCA is not going to continue it.”

Mission Health/HCA did not return request for comment on its future EMS plans in Madison County by Feb. 1.

Merger’s impact on future contracts

In a letter to commissioners dated Jan. 29, County Manager Forrest Gilliam wrote that “It is our understanding that HCA would be willing to continue providing EMS services beyond (June 30, 2020), but the County would have to absorb any cost overruns for the service.”

Should that clause appear in future contracts, Madison County could be on the hook for more than the roughly $94,000 it pays monthly for EMS coverage.

The Mountain Area Medical Airlift, or MAMA helicopter, at Mission Hospital. (Photo: Angeli Wright/awright@citizen-times.com)

“We will spend the coming months carefully exploring all cost-effective options for continuing quality EMS services in Madison County, and have a plan in place well before the June 30, 2020 contract expiration,” Gilliam wrote to commissioners regarding future EMS plans.

Asked following the Jan. 29 meeting what options Madison County had for EMS other than the new HCA entity, Gilliam said the county could explore other ambulance service providers or even operate EMS itself.

“If it is cost effective to stay with HCA, that would be our preferred choice,” Gilliam said.

Commissioner Mark Snelson, who works as an EMS supervisor for Mission Health in Madison County, recused himself from the vote to extend the EMS contract; all other commissioners voted in favor of the deal.