Tuesday night was the last chance for the public to weigh in, in Tennessee, on the proposed merger of two health systems in our region.
Here's a timeline leading up to this point. Three years ago, Wellmont Health System announced it was looking for a partner. In 2015, Wellmont confirmed its plans to merge with Mountain States Health Alliance. Their applications set off months of students and public meetings.
Then, last Fall, both Virginia and Tennessee deemed the applications complete. But the health systems asked for a delay, after the Federal Trade Commission questioned the deal.
In May, the Tennessee Department of Health deemed the merger application complete again, bringing us to Tuesday's public hearing. The meeting didn't take very long because just around a dozen people signed up to speak.
After half a dozen public hearings, Tennessee's health commissioner is still listening closely to both sides.
"I think that there are strong opinion in this room, and it's our job and obligation to discern what's best for Tennessee," commissioner John Dreyzehner said.
A majority of the dozen speakers supported the merger.
"It's absolutely the best option, nothing has changed in that," Senior VP for System Advancement at Wellmont, Todd Norris said.
Leaders at Wellmont and Mountain States said they've given both Tennessee and Virginia three more reports that suggest a merger is beneficial. Right now, the two systems said they face too much competition, working separately.
"Headwinds that were facing financially as a health system and fact that we need to keep local governance, the fact that two health systems working together can do great things," Norris listed some of the reasons he believes the merger is the best decision.
But the FTC isn't convinced.
"We feel it will lead to higher prices, lower quality, less access to care," FTC representative Alexis Gilman said
FTC representatives have been the most outspoken opponents, arguing the benefits will not outweigh the loss of competition. And they still have a lot of questions.
"Both applications submitted by parties and additional information submitted in consultant reports had high-level statements about goals and objectives, but don't really have details on how any of it will be accomplished," Gilman said.
Mountain States and Wellmont said they will continue to give any more information that's needed. But Dreyzehner said he's confident he has what he needs to meet the deadline.
"September 19th is the deadline for a decision so we will certainly make it by then, if not before," he said.
The health systems need similar approval in Virginia. In the Commonwealth, the application is called a Cooperative Agreement. In Tennessee, it's a Certificate of Public Advantage. Virginia's health commissioner must also decide whether to approve it by mid-September.
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