Tennessee State Agency Gives Hospital Monopoly Free Pass Despite Poor Performance
A Tennessee agency responsible for overseeing the nation’s largest state-sanctioned hospital monopoly, Ballad Health, has been criticized for awarding full credit on quality-of-care measurements regardless of the hospitals’ actual performance. Despite consistently falling short of performance targets, Ballad has continued to receive A grades and approval from the Tennessee Department of Health.
The scoring rubric used by the state largely ignores the actual quality of care provided by Ballad hospitals, with only 5% of the final score based on performance. This has led to Ballad avoiding penalties for failing to meet the state’s goals in areas such as surgery complications and patient satisfaction.
Critics, including patients and former state monitors, have raised concerns about the lack of accountability for Ballad Health, which was created as a result of a merger that waived federal anti-monopoly laws. Since becoming the only option for hospital care in a 29-county region, Ballad has failed to meet baseline values on 75% or more of all quality measures.
Calls for a change in the scoring rubric have been made, with former state monitor Larry Fitzgerald stating that Ballad should be required to show improvement on these measures. Despite the concerns raised, the Tennessee Department of Health continues to award Ballad high scores, claiming that the benefits of the hospital merger outweigh the risks of a monopoly.
The Virginia Department of Health, which also oversees Ballad, has faced delays in its assessments of the company. The Federal Trade Commission has warned against hospital monopolies, citing increased prices and decreased quality of care. With Ballad failing to meet quality measures and facing criticism for its performance, calls for stronger regulation and oversight of the hospital monopoly have been growing.
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