Dang!

Then there are the problems with the Ballad Health monopoly in that area.

In a news release, the Tennessee Department of Health (TDH) said the revisions cover five key areas: prioritizing quality of care, overall system scoring, rural hospitals, charity care, and listening sessions with the public.

The health system’s annual “score” from TDH — a key to its continued operation — will now see quality of care count 40%, double its previous 20%. Most of that 40% will be a pass/fail measure, which also differs from the previous TOC.

Ballad Health’s Hospital Monopoly Underperformed. Then Tennessee Lowered the Bar.

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 published last year.

In Tennessee, the Ballad monopoly is regulated through a 10-year Certificate of Public Advantage agreement, or COPA — now in its seventh year — 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.

Alas. What?!?! There is a medical school in Johnson City. Why can't there be an associated hospital?