NEW MISSION.

• Author: Mildenberg, David
• Position: STATEWIDE: West

In March, Mission Health CEO Ronald Paulus told BUSINESS NORTH CAROLINA that hospital industry consolidation is likely to continue "for a long time." Less than a month later, Paulus announced the Asheville-based system's pending sale to industry giant HCA Healthcare. Details won't be disclosed for months as the companies and regulators study the transaction, though Paulus hinted that more than $ 1 billion will flow from Nashville-based HCA into a foundation supporting health care programs in western North Carolina. As a private company, HCA also would pay tens of millions of dollars in property-tax revenue that not-for-profit Mission now avoids.

Selling Mission to a publicly traded company surprised many industry executives in North Carolina, where only 17 of the 138 hospitals are owned by for-profits, according to the N.C. Healthcare Association. None of the state's big systems are privately owned. But HCA, which reported a $2.2 billion profit last year, isn't likely to stop its expansion in the west. "HCA has said they are incredibly impressed with our management team," Paulus says. While a lot can change, he envisions "mostly the same people doing mostly the same things with a lot of additional hours involved."

Industry analyst Anu Singh told the Fierce-Healthcare newsletter that Mission officials were likely impressed with HCA's desire to use the system as a...