The decision to sell nonprofit Mission Health to for-profit HCA Healthcare was made behind closed doors, without public review, and, contrary to promises made by Mission's leadership at the time of the 2019 sale, did not lead to lasting improvements at Mission Hospital, according to the final two installments of an academic study of the merger. Though HCA made improvements to the western North Carolina health care system, according to the Wake Forest University report, many were already planned or required by then-Attorney General Josh Stein as part of the terms of the sale. "[I]t is difficult to point to any concrete lasting improvements that HCA has brought to Mission Hospital," the report states. "It is telling that, even under the most favorable viewpoints, there is no credible voice openly claiming that Asheville and western North Carolina are actually better off now with HCA at the helm of Mission."
