Adventist Health System will acquire Mid-Columbia Medical Center (MCMC) following approval of the transaction from the Oregon Health Authority’s (OHA) Health Care Market Oversight (HCMO) program on Thursday.
OHA reviews proposed healthcare business deals through the HCMO program to ensure they support statewide goals related to cost, equity, access, and quality. HCMO approved the transaction with several conditions after numerous community members raised concerns that Adventist, a faith-based organization, might restrict access to care for certain services.
The $100 million transaction will allow Adventist to acquire MCMC, a nonprofit that operates a community hospital, a cancer center, and 22 healthcare clinics in and around The Dalles. Healthcare services offered by MCMC will continue in the area.
OHA received notice of Adventist’s request on Jan. 24th, and completed a 30-day preliminary review of the transaction to assess its likely impact to cost, equity, access, and quality. It held a 14-day public comment period and received 50 written comments. Katherine Owenswood was one of several community members who opposed the transaction due to challenges it could present for LGBTQ and BIPOC members, as well as those looking to access reproductive healthcare and end-of-life care.
“This deal would ensure the only two hospital systems in the area would be faith-based,” Owenswood wrote. “There are many people in our community who feel uncomfortable or even unsafe in Christian/Catholic faith-based settings and deserve to have access to a secular option for healthcare. If this deal goes through, the closest secular hospital option would be over an hour’s drive on a highway that is subject to seasonal road closures. This is not an accessible alternative.”
Steve Caldwell wrote in support of the transaction, however, citing the opportunity for greater access to care.
“I wholeheartedly support Adventist becoming [the] new owner of MCMC,” Caldwell wrote. “The dwindling availability of physicians in this area has been a troubling development for over a year. I am still waiting to be notified of who my new primary care provider will be to replace the one that left a year ago. One can’t help but think the resources of Adventist will be a positive for overall health services here.”
OHA’s key findings regarding the transaction included:
- MCMC is facing significant financial challenges, as it posted a $10 million operating loss in 2022, and its days-cash-on-hand is below acceptable thresholds for hospitals in the state. It recently suspended medical oncology services at Celilo Cancer Center due to staffing shortages, and OHA believed further cuts to services would occur. OHA placed conditions in place to monitor Adventist’s spending regarding the transaction’s $100 million capital commitment.
- MCMC is a critically important provider of inpatient hospital care, primary care, and specialty care to Columbia Gorge communities. Both entities asserted that the transaction wouldn’t reduce access to needed services. They expect the transaction to expand services, although that would be subject to financial and staffing constraints. OHA imposed conditions aimed at ensuring that access to essential services is maintained in the 10 years following the transaction’s closure.
- MCMC’s performance on quality measures was uneven in recent years. Adventist made commitments to improve quality that include capital investments, efforts to recruit and retain staff, and quality improvement initiatives and technology. OHA will monitor MCMC quality measures in follow-up analyses.
- MCMC is the only secular hospital serving a large geographic area, and the closest hospital is part of a Catholic health system. Public comments raised concerns that the faith-based organization may restrict access to care for some services, including gender-affirming care, reproductive health services, and Death with Dignity Act services. OHA applied conditions to ensure that Adventist and MCMC continue to make existing MCMC services available for at least 10 years following the transaction’s closure.
Based on preliminary review findings, OHA approved the transaction with conditions, noting that, “The transaction is in the interest of consumers and is urgently necessary to maintain the solvency of MCMC.”