Mission Health, based in Asheville, North Carolina, is the state's sixth-largest health system, serving much of western North Carolina. A sale to HCA Healthcare became final on February 1, 2019, in which it was sold as a nonprofit to a for-profit company. The proceeds went to a nonprofit foundation, the Dogwood Health Trust, which plans to distribute annual grants focused on healthcare.

HCA Healthcare, Inc. is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom. As of 2023, HCA Healthcare is ranked #66 on the Fortune 500 rankings of the largest United States corporations by total revenue.