HCA Healthcare Faces Backlash Over Surprise Medical Bills for North Carolina Hospital Employees
ASHEVILLE, N.C. — Registered nurses and other employees of Mission Hospital, a major healthcare provider in western North Carolina, are reeling after being hit with thousands of dollars in unexpected medical bills due to a change in their health insurance coverage that went unannounced for months. The controversy highlights a growing national concern over healthcare affordability and openness, especially for those working within the system.
Laura Law, a labor and delivery nurse at Mission hospital, is among those impacted. She faces nearly $6,000 in unforeseen expenses after taking two of her three children to several routine primary care appointments with doctors at Mountain Area Health Education Center (MAHEC) this year. Law believed these visits where fully covered under her HCA Healthcare-owned Mission Health’s Aetna plan.
“It’s so disappointing,” Law said of the change and the lack of communication. “Because I expect, as a nurse, my family shoudl also be taken care of. And even if there was just communication, I would have accepted that.”
The change, which took effect Jan. 1, saw MAHEC’s primary care services dropped from the Mission Health insurance plan. The move perhaps affected thousands of employees, but was not communicated to them for over three months. HCA Healthcare has a workforce of more than 288,000 employees across 2,000 locations in the U.S. and U.K., and its hospitals are a common source of primary and preventative care in many areas.
When asked how her family would handle the surprise medical expenses, Law said, “I really don’t know, but I guess I will have to make plans to pay a $6,000 bill that my budget does not allow.”
MAHEC CEO dr. William hathaway said the change stemmed from MAHEC’s decision to leave the Mission Health Partners (MHP) Accountable Care Organization (ACO) to participate in a new federal initiative called Making Care primary (MCP). An ACO is a group of doctors, hospitals, and other health care providers who come together to give coordinated high-quality care to the Medicare patients they serve. The new MCP is a 10-year Medicare demonstration project designed to strengthen primary care through value-based payment models.MAHEC said it was unable to participate in both MHP and MCP simultaneously.
“Effective January 1, 2025, MAHEC’s Primary Care practices – including Internal medicine and family Medicine – are under a different benefit level for employees covered under the Mission Health/HCA employee health plan,” Hathaway said. “However, MAHEC’s Specialty Practices – including Psychiatry, Obstetrics and Gynecology, Endocrinology, and Dental – remain covered at prior benefit levels.”
Hathaway added that MAHEC “valued its Mission Health/HCA partnership and would welcome the opportunity to return to prior coverage levels to continue to serve Mission Health/HCA employees with high-quality, coordinated primary care.”
Mission Health, in turn, stated it valued its relationship with MAHEC and would welcome the opportunity for them to rejoin Mission Health Partners. But the hospital has not publicly commented on why its employees were not informed of the change in coverage.
The lack of communication has fueled frustration and distrust among hospital staff. Hannah Drummond, a registered nurse at Mission and a union representative, also received a surprise bill for $847. Drummond reached out to Scott Rogers, HCA’s director of labor and employee relations, requesting information about the change. Drummond said that Rogers replied by stating,”I am not aware of any communications between MAHEC and the Hospital. I am not aware of any notices from MAHEC regarding their decision to leave MHP…. The Hospital was not aware of the change.”
Several other Mission Hospital employees reported similar experiences. Jade Hoffman, a registered nurse in mission’s surgical trauma ICU, received a bill for $2,495 after a Feb. 18 procedure at MAHEC that would have been covered before the shift. In an email sent to Mission Hospital employees on April 10, Mission Hospital CEO Greg Lowe said “Ultimately, the patient is responsible for reaching out to their benefits provider if they are not sure what their benefits are or how their claims will be processed at the start of each renewal year.”
Chris Letts, a Mission Hospital progressive care unit nurse, and their wife michelle, both covered by Mission Health insurance, learned of the change through a nurse group chat. They now face a $578 balance for routine care Michelle received in March.
“MAHEC is where my wife and I both go for primary care, psych, and my wife goes for OBGYN,” Letts said. “I had an appointment yesterday at MAHEC that I actually ended up having to keep as there aren’t other options.” Letts, a breast cancer survivor, emphasized that, “not having access to preventative care for me, it’s super, super personal.”
The situation raises questions about the obligation of employers to clearly communicate changes in healthcare coverage to their employees. A recent study by the Kaiser Family foundation found that nearly half of Americans with employer-sponsored health insurance are confused about their benefits. This confusion can lead to unexpected medical bills and financial hardship.
one potential counterargument is that employees should be proactive in understanding their health insurance coverage and any changes that may occur. While this is true, healthcare policies can be complex and tough to navigate, making it challenging for employees to stay informed. furthermore, employers have a moral and ethical obligation to provide clear and timely communication about changes that could significantly impact their employees’ financial well-being.
The situation at Mission Hospital underscores the need for greater transparency and accountability in healthcare.As patients and employees navigate the complexities of health insurance, clear and consistent communication is essential to avoid unexpected financial burdens and ensure access to necessary care.
FAQ:
Q: Why did MAHEC leave the Mission Health Partners ACO?
A: MAHEC decided to leave MHP to participate in a new federal initiative called Making Care primary (MCP), as they could not participate in both simultaneously.
Q: What does Greg Lowe suggest patients do?
A: Lowe said in his email “Ultimately, the patient is responsible for reaching out to their benefits provider if they are not sure what their benefits are or how their claims will be processed at the start of each renewal year.”
Q: Where did Chris Letts learn about the change in insurance?
A: Chris learned about the change in insurance through a nurse group chat.
Q: What is Mission Health saying now?
A: Mission Health is not commenting on why its employees were not informed of the change in coverage.Mission health, in turn, stated it valued its relationship with MAHEC and would welcome the opportunity for them to rejoin Mission Health Partners.Q: What is an Accountable Care Organization (ACO)?
A: An ACO is a group of doctors, hospitals, and other health care providers who come together to give coordinated high-quality care to the Medicare patients they serve.
