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Apodaca shoots down Mission COPA study

Park Ridge and other providers successfully blocked an endoscopy clinic but the new Mission-Pardee campus is going up on the county line. Park Ridge and other providers successfully blocked an endoscopy clinic but the new Mission-Pardee campus is going up on the county line.

The state Senate won't pursue further study of the state certificate that permitted the Mission-St. Joseph's hospital merger eight years ago, state Sen. Tom Apodaca said.

Both Park Ridge Health and Mission Health issued statements last week saying they were pleased with a state House committee report that forces health care providers in the mountains to "make every effort to resolve their differences" over competition issues.

The House Select Committee on Certificate of Need Process and Related Hospital Issues issued its final report on Dec. 6 after it studied whether the merger of Mission and St. Joseph's hospitals in 1995 curbed competition and narrowed health care access.
The Certificate of Public Advantage (COPA) has been the subject of a battle among Buncombe and Henderson county health care providers. The COPA was required, the House committee report said, "to offset the anticompetitive effects of the merger on the Western North Carolina health care market."

Park Ridge and physician practices have organized to oppose the COPA. But Apodaca, who as Senate Rules chairman controls the flow of legislation for consideration, said the state House has adequately explored the question.

"It's a House study and we told them we weren't interested in doing it," he said. "I'm most satisfied" that the COPA has not undercut competition. "I think the thing that came out of it was Mission was clear and was in compliance. I don't see any need to waste taxpayers' money by continuing this."
The COPA has been modified twice since 1995.
"Mission has submitted the reports required under the statutes and has been determined to be in compliance with the terms of the COPA Agreement," the report said. "Nonetheless, hospitals, health care providers and individuals continued to raise concerns about the increase in Mission's market power and whether the COPA agreement has been effective in balancing the anticompetitive effects of the merger."
Park Ridge officials have said in hearings on the COPA and on the joint Mission-Pardee health care campus that the Asheville hospital is engaging in a predatory practices that threaten the Fletcher hospital and other providers.
"Today's committee recommendation is a victory for preserving access and choice for patients in Western North Carolina," Graham Fields, Park Ridge's external affairs aide, said in a statement. "The Committee's decision to continue investigating Mission's activities under the COPA and consider appropriate changes to ensure a competitive healthcare landscape in the region will benefit patients, physicians and other providers in the area."
Mission's CEO said in a statement that the Asheville provider welcomed the report.


"We are pleased with the Committee's final report and are grateful for their support during this very long process," said Ronald A. Paulus, MD, President and CEO of Mission Health. "The Committee's work and related review has shown clearly that Mission has been fully compliant with the COPA. The process included a remarkable, ten-year review of all aspects of Mission's compliance with the COPA, and this affirmation should reassure any reasonable party — once and for all — that Mission has met not only the letter of the law, but the full spirit of the COPA by providing significant community benefit."

The report forces "hospitals, health care providers and individuals in the region to make every effort to resolve their differences" over the COPA before the 2013 session ends.
The committee report contained pieces that either side of the battle for market share claimed as an endorsement of their position. Mission praised the committee for confirming that it had complied with the COPA. Park Ridge pointed to findings that suggested the situation still might bear looking into.
"Further in-depth investigation into the economic impact of Mission's COPA on the health care market, especially in light of recent changes in the structure of the health care industry, may be necessary to resolve these issues and ensure the provision of low cost, high quality health care to the people in Western North Carolina," the report said.