Virginia says it closely monitors Ballad, but reports are not available to the public

Virginia health officials say they are delivering on a promise of vigilant oversight of Ballad Health to ensure that people living in the coalfields gain access to better health care.

But two years since the creation of Ballad, the state has yet to release quality, access and financial reports with the public. And people living in far Southwest Virginia have yet to be given a public forum to tell regulators whether Ballad is living up to a list of conditions to ensure access to health care, to improve its quality and to do so without hiking prices.

Ballad was created two years ago this month when regulators in Virginia and Tennessee allowed two competing health care systems to merge and have a monopoly on the region’s health care.

Since then, the states’ regulators say they have worked closely with each other and with Ballad to ensure that the health system has been meeting its obligations.

Tennessee’s health department has posted Ballad’s quarterly and annual reports, along with correspondence from its health commissioner when Ballad has sought changes to its hospitals and services.

On Tuesday, the Tennessee local advisory group will hold its second annual public hearing in Bristol to hear from patients, families and employees about their experiences with Ballad.

Although the Southwest Virginia Health Authority recently created a task force to provide a similar function, it has yet to name all the members or set a hearing date.

During last year’s hearing in Tennessee, hundreds of people packed the auditorium at Northeast State Community College and dozens criticized Ballad.

Some of them lived in Virginia and said they were upset about Ballad’s plan to downgrade the level of trauma care in Kingsport and Bristol, the two closest Tennessee hospitals.

Speakers were also upset about Ballad’s plan to close its neonatal intensive care unit in Kingsport in favor of boosting the one in Johnson City, Tennessee.

While Ballad needed Tennessee’s approval to make these changes, it did not need Virginia’s. It was required to provide a plan for how Virginia’s emergency services and response times would be affected, but the state did not post that report online.

Neither Virginia nor Tennessee had experience in approving and overseeing a health care monopoly and were obligated to develop their own regulatory frameworks without consulting each other before the merger. While many of their requirements are similar, each state created its own list of quality and population health measures.


Tennessee has continued to post on its website Ballad’s quarterly and annual reports. Virginia does not do this, nor has it explained why it does not.

Virginia Health Department spokeswoman Maria Reppas said that Virginia now has a number of employees working on oversight and that its monitors have met with Ballad and with Tennessee’s regulators weekly since June.

They have worked to develop “a robust measurement structure” that the state will use to evaluate “whether the benefits of the Cooperative Agreement continue to outweigh any disadvantages,” she said.

Their recommendations were forwarded Friday to Virginia’s health commissioner, she said, and once he approves, the department “will develop a public-facing dashboard to display data pertaining to the updated metrics framework, complaint information and other reporting requirements.”

She said they don’t know when it will go live. A Health Department official last summer said he expected a data dashboard to be launched within weeks. He also said that much of what Ballad submits to the state cannot be released to the public, as Ballad claims it is proprietary.

Last summer, after Ballad ceased performing surgeries at one of its three Wise County hospitals without notifying the public, Southwest Virginia Health Authority members began discussing entering into a contract with the state that would give it a greater oversight role and to set up a task force to give the public a voice.

On Friday, the authority received its first written report from its monitor and said the task force would meet at least four times in 2020.

[This article was originally published by The Roanoke Times.]