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

The Holston Valley Medical Center in Kingsport, Tennessee, is part of the Ballad Health hospital system. (Brett Kelman/KFF Health News)

Despite years of patient complaints and quality-of-care concerns, Ballad Health — the nation’s largest state-sanctioned hospital monopoly — will now be held to a lower standard by the Tennessee government, and state data that holds the monopoly accountable will be kept from the public for two years.

Ballad is the only option for hospital care for most of the approximately 1.1 million people in a 29-county swath of Appalachia. Such a monopoly would normally be prohibited by federal law. But under deals negotiated with Tennessee and Virginia years ago, the monopoly is permitted if both states affirm each year that it is an overall benefit to the public.

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