{"id":385,"date":"2025-06-03T09:00:00","date_gmt":"2025-06-03T09:00:00","guid":{"rendered":"https:\/\/nolowlibido.com\/?p=385"},"modified":"2025-06-11T14:37:45","modified_gmt":"2025-06-11T14:37:45","slug":"ballad-healths-hospital-monopoly-underperformed-then-tennessee-lowered-the-bar","status":"publish","type":"post","link":"https:\/\/nolowlibido.com\/index.php\/2025\/06\/03\/ballad-healths-hospital-monopoly-underperformed-then-tennessee-lowered-the-bar\/","title":{"rendered":"Ballad Health\u2019s Hospital Monopoly Underperformed. Then Tennessee Lowered the Bar."},"content":{"rendered":"

Despite years of patient complaints and quality-of-care concerns, Ballad Health \u2014 the nation’s largest state-sanctioned hospital monopoly<\/a> \u2014 will now be held to a lower standard by the Tennessee government, and state data that holds the monopoly accountable will be kept from the public for two years.<\/p>\n

Ballad is the only option for hospital care for most of the approximately 1.1 million people in a 29-county swath of Appalachia. Such a monopoly would normally be prohibited by federal law. But under deals negotiated with Tennessee and Virginia years ago, the monopoly is permitted if both states affirm each year that it is an overall benefit to the public.<\/p>\n

However, according to a newly renegotiated agreement<\/a> between Ballad and Tennessee, the monopoly can now be considered a “clear and convincing” benefit to the public with performance that would earn a “D” on most A-to-F grading scales.<\/p>\n

And the monopoly can be allowed to continue even with a score that most would consider an “F.”<\/p>\n

“It’s an extreme disservice to the people of northeast Tennessee and southwest Virginia,” said Dani Cook, who has organized protests against Ballad’s monopoly for years. “We shouldn’t have lowered the bar. We should be raising the bar.”<\/p>\n

The Ballad monopoly, which encompasses 20 hospitals and straddles the border of Tennessee and Virginia, was created in 2018 after lawmakers in both states, in an effort to prevent hospital closures, waived federal antitrust laws so two rival health systems could merge. Although Ballad has largely succeeded at keeping its hospitals open, staffing shortages and patient complaints have left some residents wary, afraid, or unwilling to seek care at Ballad hospitals, according to an investigation by KFF Health News<\/a> published last year.<\/p>\n

In Tennessee, the Ballad monopoly is regulated through a 10-year Certificate of Public Advantage agreement, or COPA \u2014 now in its seventh year \u2014 that establishes the state’s goals and a scoring rubric for hospital performance. Tennessee Department of Health documents show Ballad has fallen short of about three-fourths of the state’s quality-of-care goals over the past four fiscal years. But the monopoly has been allowed to continue, at least in part, because the scoring rubric doesn’t prioritize quality of care, according to the documents.<\/p>\n

Angie Odom, a county commissioner in Tennessee’s Carter County, where leaders have clashed with Ballad<\/a>, said she has driven her 12-year-old daughter more than 100 miles to Knoxville to avoid surgery at a Ballad hospital.<\/p>\n

After years of disappointment in Tennessee’s oversight of the monopoly, Odom said she was “not surprised” by Ballad’s new grading scale.<\/p>\n

“They’ve made a way that they can fail and still pass,” she said.<\/p>\n

Virginia regulates Ballad with a different agreement and scoring method, and its reviews generally track about one or two years behind Tennessee’s. Both states have found Ballad to be an overall benefit in every year they’ve released a decision.<\/p>\n

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