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As scores of western North Carolina physicians depart Mission Health facilities in the wake of the nonprofit health system's $1.5-billion sale to for-profit giant HCA Healthcare, other local providers are broadening their footprints.

Such is the case for Pardee UNC Health Care and AdventHealth Hendersonville, two systems that each have a hospital and other physician services near Mission Health's base in Asheville.

Both Pardee and AdventHealth are in the process of signing on physicians that have recently decided to leave Mission Health facilities.

Early next month, Pardee UNC Health Care will open a new practice, Pardee Primary Care Arden, with six physicians from Mission Health. The practice will provide complete physical exams and preventive care as well as other services, such as the treatment and management of chronic diseases and mental healthcare. Pardee Medical Associates Brevard is also set to open in April, with another seven physicians from Mission Health.

AdventHealth will also add several physicians -- including those in family practice -- from Mission Health in the coming weeks.

Leaders at both organizations told 麻豆传媒 they're continuing to field interest from local physicians.

David Ellis, MD, chief medical officer for Pardee UNC Health Care, said in an email that Pardee had been "immersed and invested in both Brevard -- with urgent care, sports medicine, and orthopedics -- and in Arden for many years when the opportunity to expand our services presented itself."

Pardee is a non-profit community hospital founded in 1953 that's managed by UNC Health Care. The hospital is licensed for 222 acute care beds, and Pardee has several locations separate from its main campus.

"We were able to seamlessly expand our primary care network with the addition of two great groups of physicians who are similarly invested in their communities," Ellis said. "These physicians were interested in making a change and thankfully wanted to remain in the area and continue to care for their patients."

The family medicine physicians that will staff the new practice are Susana Barrero Arroyo, MD; Laura Hill, MD; James Lowery, MD; Christina McDonald, MD; Andrew Runkle, MD; and Christopher Sander, MD. The physicians either declined a request for comment from 麻豆传媒 or did not respond.

Physicians staffing the Brevard location will be: James Bryant, MD; Ernesto de la Torre, MD; Marshall Shane Foster, MD; Leanne Kline, MD; Harrell Royer, MD; Timothy Shea, MD; and Reid Usedom, DO.

Ellis said of the group: "When physicians choose to practice in an area for a long period of time -- and remain invested in their communities -- that's always a positive outcome for their patients, the community, and for all of us."

He said that Pardee's recruitment efforts are in response to the needs of the communities it serves in the short- and long-term. "They are measured and intentional, seeking to anticipate areas of growth or specialties that are currently stretched or that force our patients to travel for care."

Ellis added that, "If there are providers in our region of Western North Carolina that wish to remain in the area, providers not currently practicing in the region but wish to have a change in venue, or providers who no longer wish to be self-employed, Pardee remains open to discussing potential opportunities that may benefit our patients and our communities."

Christy Sneller, vice president of physician services at AdventHealth Hendersonville, concurred.

"Our AdventHealth Medical Group offices continue to see a very high interest from physicians in our region and across the country, who are looking to join our health system because of our commitment to support doctors as they provide high quality, safe care to patients," Sneller said in a statement provided to 麻豆传媒 in an email. "We are excited to be welcoming several new physicians in the next few weeks."

They'll be joining at sites across Buncombe, Henderson, and Transylvania counties, according to a spokeswoman for AdventHealth Hendersonville. Some of the physicians -- though not all -- were previously at Mission Health. The sites include AdventHealth Medical Group Family Medicine at Black Mountain, Brevard, and Mills River as well as AdventHealth Medical Group Rheumatology and AdventHealth Medical Group Family Internal Medicine, both in Hendersonville.

Some locations are welcoming multiple providers to the practice, the spokeswoman said. AdventHealth Hendersonville has also recently added several providers to the teams of hospitalists and anesthesiologists at its hospital.

"We have had some inquiries from medical groups that left Mission/HCA," Sneller added. "However, most of the larger medical groups in our region already had privileges at multiple local facilities, including AdventHealth Hendersonville."

The hospital has served western North Carolina for more than 100 years. It's a member of AdventHealth, which has dozens of non-profit, faith-based hospitals across the country.

As for Mission Health, physician and other staff departures have been just the latest area of scrutiny since its sale to Nashville-based HCA. There have also been allegations from the local community of complex charity care and a drop in quality of services, among other concerns.

With its origins in 1885, Mission Health is a seven-hospital system that serves 18 largely rural counties in North Carolina. Its deal with HCA was touted as a way to provide the necessary resources for long-term sustainability while maintaining the same access to care.

Nancy Lindell, director of public and media relations for HCA's North Carolina division, said in an emailed statement that some of the physician departures have come on the heels of the transition to new contracts.

"Our primary care physicians were offered contracts aligned with Fair Market Value as the next step in transitioning them to HCA Healthcare contracts," Lindell said. "Previous contracts with Mission Health had non-compete clauses in them and based on the auto-renew language in the previous contracts, we afforded the opportunity for a one-time waiving of the non-compete to either accept the new contracts HCA Healthcare offered or to choose other local practices, so that physicians could consider other options and remain in the communities where our hospitals are located."

Lindell added, "While some have chosen to pursue other local options, we are confident that most will continue to care for our community here in Western North Carolina as members of our Mission Health medical staff." She reiterated that Mission Health is actively recruiting to fill any expected vacancies, and that it has recently signed contracts with a number of new providers.

"Our primary care locations continue to be available to the community for their care needs, and we are prepared to expand staff as the needs of the community expand," Lindell said. "HCA Healthcare continues to expand their support of physicians across all of Western North Carolina and while the employment relationship with some has changed, these physicians are still part of our medical staff and hospital team."

To date, Dogwood Health Trust -- a foundation formed with proceeds from the sale to monitor HCA's compliance with obligations of the deal -- hasn't notified HCA of any issues of noncompliance. However, 麻豆传媒 reported in February that the recent or impending loss of more than a dozen physicians has caught the attention of the North Carolina Attorney General's office as well as the independent monitor put in place to advise Dogwood Health Trust.

The independent monitor, Gibbins Advisors, said last week that it will April 7 open to all communities in western North Carolina served by Mission Health.

Gibbins Advisors said the webinar is intended as a "refresher" event from last year's seven in-person community meetings. The independent monitor team, it said, will provide an update on its work as well as the opportunity to ask questions.

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