ASHEVILLE, N.C. (WLOS) — A national organization said patients worried about doctors leaving Mission Health shouldn't panic.
It has been two years since HCA bought the hospital, and News 13 has confirmed 79 doctors have left or plan to leave.
But, the Association of Independent Doctors said the departures could end up being a win for patients and doctors.
Dr. Thomas German was a primary care doctor with Mission Health until HCA closed the clinic where he worked.
"I'm pretty worried about the future locally," said German, who is invested in the local health care system and his former patients.
He has decided to take a job at Appalachian Mountain Community Health Centers, a federally qualified health center.
"I think some grief is the biggest thing, and there's been a lot of grief this last year, obviously, with the pandemic, and seeing something that could have been really good kind of go downhill," German said.
News 13 previously reported that 55 doctors have left or plan to leave Mission since the sale to HCA. Since then, News 13 has confirmed another 24 have left or plan to part ways. Those leaving include surgeons, cardiologists and psychiatrists.
CLINICS CLOSED, DOZENS OF DOCTORS LEAVE MISSION HEALTH SINCE HCA TAKEOVER
"But, if we start to lose quality physicians long term, then the overall health of our community starts to decline. Many of the services and specialty things that were available through Mission and CarePartners have also gone by the wayside. It's very sad to see really high quality physicians, really high quality services, physical therapists, mental health workers, all leaving this system," German said.
German said he is also worried about his patients' future. He's worried about a lapse in care and a degradation in the quality of care.
At the time, Mission Health officials said patients using clinics targeted for closure were being contacted about transitioning their care to nearby providers.
Mission Health also sent the following statement in response to News 13 questions for this report:
Our primary care physicians were offered contracts aligned with Fair Market Value as the next step in transitioning them to HCA Healthcare contracts. Previous contracts with Mission Health had non-compete clauses in them and based on the auto-renew language in the previous contracts, we afforded Physicians the opportunity for a one-time waiving of the non-compete to either accept the new contracts HCA Healthcare offered or to choose other local practices, so that Physicians could consider other options and remain in the communities where our hospitals are located. While some have chosen to pursue other local options, we are confident that most will continue to care for our community here in Western North Carolina as members of our Mission Health medical staff. We are actively recruiting to fill any vacancies that we anticipate, and recently signed contracts with several new providers. Our primary care locations continue to be available to the community for their care needs, and we are prepared to expand staff as the needs of the community expand. HCA Healthcare continues to expand their support of physicians across all of Western North Carolina and while the employment relationship with some has changed, these physicians are still part of our medical staff and hospital team.
Mission Health Partners (MHP) has been in place since 2014 and remains active as a Medicare ACO. By also partnering with Pardee, Murphy Medical Center and independent practices, MHP is supporting local primary care. Since the acquisition, HCA Healthcare has been very supportive of Mission Health Partners. MHP is currently participating in several other value-based contracts and will continue to do so."
But the Association of Independent Doctors said, in the long run, physician departures could be a win for doctors and patients.
"This is a healthy transition. There may be some growing pains. The hospital may have to reduce some overhead in order to survive, but this, in the long run, it's healthy for doctors, it's healthy for patients if the doctors can be their own doctors," Carey said.
Association of Independent Doctors executive director Marni Jameson Carey has watched as HCA has bought health systems in other cities and believes it's better if providers are not employed by the hospital.
"It's a good thing. It's a good thing for patients when doctors are independent," Carey said.
TWO YEARS AFTER SALE TO HCA, CARE AND COST CONCERNS RAISED WITH MISSION HOSPITAL
Many Mission doctors said new contracts demand more work for less pay.
"If a hospital comes in and is giving a doctor a contract that he or she does not want to sign on to and a doctor decides to go on his or her own way, that's a good thing. That will be higher quality for the patient, more independence for the doctor, better care all around," Carey said.
Cary believes independent doctors have more freedom when it comes to referring patients and they’re less expensive.
"The same visit is half the price or less at an independent doctor's office than it is in the hospital," Carey said.
MISSION HEALTH SIGNS AGREEMENT TO BE ACQUIRED BY FOR-PROFIT HCA HEALTHCARE
But German said the price for doctors to be on their own is high.
"It is difficult. Primary care is on the lower end of reimbursement for what we do," German said.
He explained that it's not just hard to keep afloat financially, but there is also a lot of red tape involved.
German said when a doctor switches employment, it takes three months of paperwork just to get recredentialed by insurance companies. He said, during that time, doctors are unable to see patients.
He said he is also worried about where patients that used to be caught in Mission's safety net will end up.
AMBULANCE DELAYS AT MISSION ER RAISE CONCERNS
"If you try to run an office on your own as a private doctor or private practice, you cannot have a high percentage of Medicaid or Medicare. It just doesn't pay at the level you would need to maintain a practice," German said.
He said more private practices and more community clinics could pop up, and he hopes they will fill the gaps.
"But the quality of some of the services that Mission had in regards to like diabetes education and they had a chronic conditions clinic, those things were really valuable, and we've just seen them go away," German said.
Coming up at 6 p.m. Thursday, hear from other local hospital groups about the number of doctors leaving Mission Health.