"It's clear that we've been as compliant as one could realistically get with the COPA," Mission CEO/President Ron Paulus told members of the media. "Whatever questions people have raised, they've now been definitively answered."
These questions usually concern whether or not Mission Health is acting as a monopoly. One group, the WNC Community Healthcare Initative, calls Mission's behaviors "aggressive." However, Paulus says he hopes these reports will silence the naysayers.
"For those who have raised conners, we have been reviewed and completely identified as being 100 percent compliant," Paulus said.
Issued by the state in 1995, the COPA allowed Mission to merge with St. Joseph's Hospital — but only if Mission agreed to state regulation. Voluntarily, Mission agreed and has been in the agreement ever since. However, earlier this year, Mission Health urged the House Select Committee on the Certificate of Need Process and Hospital Issues to reconsider.
Despite a grassroots letter-writing campaign, the committee did not adopt any changes to Mission's COPA in April, keeping its regulations on the health system in place. Though Paulus says the health system has no specific plan to withdraw from the COPA at this time, he did say that some regulations will need to be revisited. One of those is the physician cap. Under the agreement, Mission Health must adhere to a physician employment cap that says the health system cannot hire more than 30 percent of physicians in its service area.
Paulus argues that this might place a limit on the kind of care Mission Health can provide. "Just in primary care alone, we have at least a deficit of 140 physicians, and that's compared to even the most optimistic number of assumptions of physicians that we should have in the region," Paulus said.
Last week, Mission Health opened Mission MyCare Plus, a comprehensive primary care practice. The 11,000-square-foot facility features 15 patient exam rooms, two medical procedure suites, a full pharmacy, an X-ray machine and a physical therapy suite. And, every physician hired to work there counts toward the 30 percent physician cap — and this center is the first of many.
"We're not fixated on whether we employ everybody or not. If those private physician groups are not viable, or can't or won't recruit physicians, somebody has to fill that gap. We're the only ones within our core market that has the ability and desire to step up and build those needs," he said.
Also of note, the reports also showed that Mission is doing more with less. The audits, conducted by Dixon Hughes, an accounting firm chosen by the Attorney General's office and paid for by Mission Health, showed that last year Mission Health's cost per case was $426 less than comparable hospitals. And, Mission's restraint on prices resulted in an operating margin being $62.3 million less than allowed under the COPA.
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