After Appalachian hospitals merged into a monopoly, their ERs slowed to a crawl
After Appalachian hospitals merged into a monopoly, their ERs slowed to a crawl
Ballad Health was granted the nation’s largest state-sanctioned hospital monopoly in 2018. Since then, its emergency rooms have become more than three times as slow.
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Ballad Health, a 20-hospital system in the Tri-Cities region of Tennessee and Virginia, benefits from the largest state-sanctioned hospital monopoly in the United States. In the six years since lawmakers in both states waived anti-monopoly laws and Ballad was formed, ER visits for patients sick enough to be hospitalized grew more than three times as long and now far exceed the criteria set by state officials, according to Ballad reports released by the Tennessee Department of Health.
Tennessee and Virginia have so far announced no steps to reduce time spent in Ballad ERs. The Tennessee health department, which has a more direct role in regulating Ballad, has each year issued a report saying the agreement that gave Ballad a monopoly “continues to provide a Public Advantage.” Department officials have twice declined to comment to KFF Health News on Ballad’s performance.
According to Ballad’s latest annual report, which was released this month and spans from July 2022 to June 2023, the median time that patients spend in Ballad ERs before being admitted to the hospital is nearly 11 hours. This statistic includes both time spent waiting and time being treated in the ER and excludes patients who weren’t admitted or left the ER without receiving care.
This is a relevant line:
In the six years since lawmakers in both states waived anti-monopoly laws...
This is inexcusable.
I live here and it sucks. Most of these hospitals are small and there’s only a few large ones that handle everything. My friend had a heart attack a few weeks ago and was in the ER hallway almost 24 hours before a room opened up and she could be admitted. The staff itself was great but UGH yes the wait times are awful at the main hospitals.
The weird thing is this is the exact argument many people give for socialized medicine: the wait times. "Imagine if the hospitals were run with the efficiency of the DMV. A,trak, or the Post Office," meant as a negative slant. "Imagine if FedEx was the only game in town, and to mail letter was $10, and to receive mail and packages was a $25/mo service charge, plus fees for every item delivered."
My parents still live in this area and have emailed me non stop about this since the beginning.
They live in a county that HAD two large hospitals. Both got absorbed by this cancer. One got shutdown.
All their ‘old’ reputable doctors took retirement when Ballad took over. Any younger doctors were forced to join Ballad or GTFO of town. Ballad had not only a monopoly on the heath care but if you were in any sort of field related (say you were an eye doctor) and you had your own practice but you occasionally went to the hospital to see patients - you were no longer allowed in the hospital unless you joined Ballad.
Basically you were blackmailed to joined these assholes or else. I found this out from some friends who stayed in the area and joined the medical field.
Seriously, the fact TN allowed this shit to pass just irritants me to no end.
The Tennessee health department, which has a more direct role in regulating Ballad, has each year issued a report saying the agreement that gave Ballad a monopoly “continues to provide a Public Advantage.” Department officials have twice declined to comment to KFF Health News on Ballad’s performance.
The "advantage" is money and profits at the expense of the members of the public. So taking advantage, not public advantage.
For profit healthcare is a bane on society. Health shouldn’t be profit driven.
You know the worst part about BalladHealths creation?
The federal government FTC blocked it, so then they paid off senator Rusty Crowe to draft a law specifically just for BalladHealth so they could take over with "local" oversight through some bullshit called a "COPA" (which is apparently not being followed at all)
BalladHealth should not fucking exist
Thanks for the links. I like reading stories like this when someone more familiar with the situation can fill the rest of us in a bit more.
From an article linked in the second reference you give:
The merger was profitable for Levine [Ballad CEO] too. His total compensation has nearly doubled to about $4.3 million since the merger, including some deferred retirement payments, according to reports filed with the IRS. Prior to Ballad, Levine worked as a high-level health official in Florida and Louisiana and was an executive at two larger hospital corporations, HCA Healthcare and Health Management Associates. Federal prosecutors accused both companies of widespread health care fraud during some of the years when Levine was one of their leaders, claims the companies denied but later paid hundreds of millions of dollars to settle.
Nothing to see here...
But then there is this:
Nationwide, the COPA model is uncommon but gaining momentum. COPAs have been used in about 10 hospital mergers over the past three decades, including two in Texas and one in Louisiana in just the past three years, and another is being proposed in Indiana. Nineteen states have laws on the books allowing for COPAs, although not all have approved a specific merger...
“Our critics say, ‘No Ballad. We don’t want Ballad.’ Well, then what?” Levine said. “Because the hospitals were on their way to being closed.”
So what do we do about this? This seems to go back to red states being propped up financially by blue states. By nature of population and development, that seems to be the order of things, and I don't mind that in general principal. It seems like nationalized healthcare would allow quality hospitals to exist in unprofitable areas, just like post offices don't go out of business there. But if people there keep voting for reps that keep going on about "socialism evil!" how do we get these people care? In a capitalist system, how do we force businesses to provide service when it is unprofitable, leaving only unscrupulous people to provide those services like slumlords of healthcare?
It really sucks and I feel bad for the people affected, but what can really be done since it seems that is the path they choose?
Tennessee governance at its finest.
Literally, it's the best these chuckleheads can do
One company that bought up most of the hospitals and small practices just up and decided to move out of the area, fire thousands of people and NOT sell the hospitals to people that put in offers. They DIDNT work with the cities they left. They sent a piece of mail to me letting me know I had 30 days to get prescriptions from my PCP and that I wouldn't get any more. Now I have to find a new doctor... While working full time during the hours of doctors... While hoping to God my ADd meds last until I get a new doctor. They didn't even pretend to try to work with anyone in the area on this. They don't give a fuck about the people. This is not an industry that should be ran by corporations.
One of the hospitals they are closing is jam packed, filled to the brim every day. How the fuck is it legal for them to just up and leave without working on a plan to slowly leave the area or transition to another company?
I worry about Mayo Clinic sometimes. Centralization is good, but only when that entity isn't for-profit.
Well that really sucks for me too.
of all the places to not have easy access to healthcare....
As a Tennesseean:
Lol, sucks to suck, rurals
If people took personal responsibility the half a remaining ER wouldn't be so over run! Really it's very efficient and people just aren't giving credit where it's due. Just look at these charts of irrelevant numbers!