Indiana hospitals pull merger application after pushback over monopoly concerns

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Two rival hospitals in Terre Haute, Indiana, pulled back their merger application Monday, just days before the state was due to rule on the deal amid growing backlash to such medical monopolies.

KFF Health NewsNov 26 2024

Union said it plans to submit a new application after working with Indiana regulators to "ensure the benefits" such as "improved access, quality" are included. "There could be any number of reasons why they pulled the application with the stated intention to refile," said Christopher Garmon, a University of Missouri-Kansas City economist who has studied COPA mergers. Given the status of the application, he said, it's unlikely the deal was headed toward an approval. "Either way, I think it's clear that the state was not ready to approve the COPA with conditions similar to past COPAs.

"We know that COPAs generally benefit the merging hospitals, but not local residents," said Zack Cooper, a health economist and associate professor at Yale University. In 2018, Ballad Health formed as the nation's largest state-approved hospital monopoly, with COPA agreements in Virginia and Tennessee. Since then, KFF Health News has reported, Ballad has fallen short on meeting quality and charity care goals, according to annual reports from Ballad and the Tennessee Department of Health. After years of complaints from patients, the state is now trying to hold Ballad more accountable for its quality of care.

Last year, government inspectors found "deficiencies" at Mission Health that contributed to four patient deaths and posed an "immediate jeopardy" to patients' health and safety, according to the 384-page federal inspection report. HCA has said it promptly addressed the issues. But the state and the hospital system are now engaged in a lawsuit.

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FTC, Indiana residents pressure state to block hospital mergerIndiana residents and federal officials are urging state health regulators to stop two rival hospitals in Terre Haute from merging.
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