Six Years Into an Appalachia Hospital Monopoly, Patients Are Fearful and Furious - KFF Health News

Ballad Health , a 20 -hospital system in northeastern Tennessee and southwestern Virginia , is the only option for hospital care in a large swath of Appalachia .

Some local residents have become wary, afraid, or unwilling to seek care at Ballad hospitals.

Ballad formed six years ago when lawmakers in both states, in an effort to prevent hospital closures, waived federal antitrust laws.

Ballad Health was created in the nation’s biggest hospital merger, based on what called a Certificate of Certificate of Public Advantage , or COPA .

Ballad is now the only option for hospital for most of the 1.1 million people in a 29 -county region.

Despite concerns, Tennessee and Virginia officials have each year determined that the benefits of the monopoly outweigh negative impacts.

In 2020 , Bristol Regional Medical Center CEO resigned after it was discovered he made the initial incision in a heart surgery despite not being a doctor.

In 2022 , 14 cardiologists signed a letter warning of “severe limitations” in the Bristol Regional cardiac catheterization lab.

In 2023 , Ballad Health was ranked last among 200 large health care organizations in an analysis of nurse satisfaction.