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Hospital mergers run amok? When states disregard warnings from the FTC

Many states have passed laws that allow hospital systems to merge into monopolies, making them difficult to control and causing a decrease in care – and public records suggest that's exactly what happened at Ballad Health.

By Brett Kelman and Samantha Liss | October 02, 2023 at 11:32 AM
nurse standing by patient in hospital bed (Photo: Shutterstock)

Five years ago, rival hospital companies in the blue-collar corner of Appalachia – in Johnson City, Tenn. – made a deal. If state lawmakers let them merge, leaving no competitors, the hospitals promised not to gouge prices or cut corners. They agreed to dozens of quality-of-care conditions, spelled out with benchmarks, and to provide hundreds of millions of dollars in charity care to patients in need.

Today, Ballad Health’s 20 hospitals remain the only option for hospital care for most of about 1.1 million residents in a 29-county region at the nexus of Tennessee, Virginia, Kentucky, and North Carolina. But Ballad has not met many of the quality benchmarks nor provided much of the charity, spurring discontent among those with no choice but to rely on Ballad for their care.

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