HCA Healthcare announced Friday it has signed a definitive agreement to purchase Mission Health for $1.5 billion.

Under the agreement, proceeds of the sale of not-for-profit Mission to investor-owned HCA will go into Dogwood Health Trust, a not-for-profit fund that will use the money to improve the health and well-being of western North Carolina residents.

Nashville-based HCA is set to acquire the North Carolina system’s 763-bed flagship hospital and 80-bed CarePartners Rehabilitation Hospital, both in Asheville; 49-bed Mission Hospital McDowell, Marion; 25-bed Angel Medical Center, Franklin; 25-bed Transylvania Regional Hospital, Brevard; 25-bed Blue Ridge Regional Hospital, Spruce Pine; and 24-bed Highlands (N.C.)-Cashiers Hospital.

North Carolina’s attorney general has 90 days from the signing of the definitive agreement to review the deal. The Internal Revenue Service, the CMS and the Federal Trade Commission will also be able to review the deal.

Representatives with Mission and HCA were not immediately available for comment. The two health systems signed a letter of intent in March.

“Mission Health is the premier healthcare system in western North Carolina, with a 130-year tradition of high quality patient care,” HCA CEO Milton Johnson said in a statement. “We look forward to continuing Mission Health’s focus on excellence, and investing in western North Carolina to improve the health of the region.”

HCA currently has no operations in North Carolina, and a Modern Healthcare Metrics analysis determined it may see a fellow market leader in Mission, which holds a 49.5% market share across the 11 counties it operates in.



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