Huntsville Hospital’s acquisition of Crestwood Medical Center, the city’s only other hospital, is raising questions about healthcare in north Alabama.
Community Health Systems agreed to sell the assets of the 180-bed Crestwood Medical Center, along with its outpatient center and practices, for $450 million. Social media comments on the merger raised concerns over quality, access to treatment and workers’ rights and pay.
“This is not a good thing. Huntsville is too big to not have choices in healthcare,” a commenter noted.
Labor leaders like North Alabama Labor Council President Jacob Morrison agreed. In a statement, he said the change could result in higher healthcare prices.
“Nationally, we have seen a trend in corporate consolidation and this trend has not benefited working people or consumers,” he said.
Morrison pointed to New Orleans as an example. In 2015, LCMC Health System held 25% market share, and its charge-to-cost ratio was lower than that of most other hospitals in the region.
“Now that they own 57% of the market share and their only competitor owns 41% – meaning the top two healthcare providers own 98% of the market share – LCMC Health’s charge-to-cost ratio significantly outstrips the regional average, now charging an average of $576 for every $100 in costs,” Morrison said. “What will happen in Huntsville when one provider owns 100% of the market?”
However, data provided by Huntsville Hospital Health System shows its average charge-to-cost ratio has actually decreased related to its market share. From 2022 to 2025, the system’s state market share has grown by 7% while the charge-to-cost ratio has dropped by 5.7%, hospital officials said.
In a statement, HHHS officials added that there will still be healthcare options for patients.
“Huntsville Hospital Health System understands the importance of preserving patient choice for our community,” officials said. “Rest assured, patients will continue to be able to choose Crestwood Medical Center for their care and see the providers they know and trust. Whether it’s due to convenience or personal preference, our focus is to ensure that Crestwood will continue to remain a choice for local care.”
Regulators must sign off on the deal. HH Health System representatives directed questions about acquisition details to Community Health Systems. CHS did not respond to a request for information.
The acquisition is set to be complete by March 31.
Labor concerns
Others had labor concerns. Huntsville Hospital posted full-time bedside RN positions with a $25 to $41 per hour pay range. The national average pay is $44.56, according to Indeed, the job search site.
Morrison said workers at Huntsville Hospital and Crestwood should be concerned that management will want to keep pay down.
“Huntsville Hospital already pays its workers much too little, but its stinginess was no doubt tempered to some degree by the fact that right down the road, nurses could go work for higher pay. When this check on Huntsville Hospital is removed, what will happen to the already low pay of nurses inside Huntsville Hospital?”
HHS officials said it will continue to increase pay for its employees and is in the process of making additional adjustments.
“Our staff remains central to everything we do, and we will continue to prioritize both their support and the needs of the community,” HHS said. “In addition, previously announced compensation adjustments for HH Health employees remain underway, as well as customary merit pay increases.”
Huntsville also addressed the pay issue in its fact sheet regarding the acquisition.
“Employees at Crestwood Medical Center will work for HH Health in a similar manner as they work for CHS today,” the notice said. “Employees can expect general operations to remain the same, as well as pay and benefits to remain comparable.”
Question about monopoly
HHS said the acquisition will allow for both hospitals to be “better positioned to manage patient capacity and improve access to care, especially in high-demand areas such as emergency and maternity services.
“We envision opportunities to better coordinate community EMS resources, develop a single regional electronic medical record system for continuity of patient care and patient convenience, strengthen clinical service lines, expand clinician and workforce development and training and enhance community partnerships,” the hospital said in a statement.
But concerns over a healthcare monopoly in Alabama’s most populated city continue, with some people on social media circulating a link to file a complaint with the federal Antitrust Division. That division enforces the Clayton Act, which “prohibits companies from merging when the merger may substantially lessen competition.”
The not-for-profit Huntsville Hospital Health System has acquired 10 hospitals and two physician clinics since it was established in 1895. It built and opened Madison Hospital in 2012.
There are approximately five large health systems in North Alabama that are not owned by Huntsville Hospital Health System: North Alabama Medical Center, North Alabama Shoals Hospital, Cullman Regional Medical Center, Russellville Hospital and Gadsden Regional Medical Center.
