The Georgia Hospital Association has split, losing Piedmont Healthcare and its 11 Georgia hospitals.

Piedmont's loss is a significant blow to the association, which lobbies for the state's hospitals. GHA has been for years their heavyweight fighter in the battlebetween nonprofit hospitals and for-profit businesses such as Cancer Treatment Centers of America over state protections for the nonprofits.

The split has no effect on patients or what the average citizen sees in their health care. But if the hospitals lose ground in future battles over legislation at the state Capitol, it could cause nonprofit hospitals to lose revenue. As GHA now goes to make its arguments before elected officials in the state Capitol in the upcoming legislative session, it can no longer present itself as automatically representing the interests of all hospitals.

AJC file photo

Credit: Alyssa Pointer

icon to expand image

Credit: Alyssa Pointer

Ethan James, the association’s executive vice president, insisted he did not expect GHA’s influence on major issues to weaken, because the association’s message was unified with Piedmont’s interests.

“Piedmont has been at the table and even had membership on our board of directors and been fully aligned with the vast majority of the perspectives of the industry,” James said.

For its part, Piedmont said in a statement that its dues to GHA had just risen too high. In the association, big metro hospitals with more revenue tend to pay higher dues. Piedmont has its own lobbyists and can still make its arguments at the Capitol.

But the split comes in the wake of an intense, long-running battle over hospital regulations, in which hospitals ceded ground last year. It was a brutal legislative fight and Piedmont at one point worked apart from GHA to make separate legislative suggestions.

>> READ | Lawmakers vote to ease restriction protecting nonprofit hospitals

The regulations they fought over, called certificate of need, govern whether businesses can cherry-pick the most lucrative types of cases, such as orthopedic surgery or cancer treatment, and leave hospitals to serve expensive cases, such as long-term neonatal care.

Community hospitals argue that if the businesses do that too much the hospitals could go bankrupt or have to cut back.

<p> FILE - In this Oct. 17, 2018 file photo, Lanie Eden and her husband Ron stand in the destroyed vacation home they rented every year as they look for their possessions in the aftermath of Hurricane Michael in Mexico Beach, Fla. The tropical weather that turned into monster Hurricane Michael began as a relatively humble storm before rapidly blossoming into the most powerful cyclone ever to hit the Florida Panhandle, causing wrenching scenes of widespread destruction. (AP Photo/Gerald Herbert, File) </p> <p> Aleeah Racette receives medical treatment inside the Florida 5 Disaster Medical Assistance Team tent, outside the Bay Medical Sacred Heart hospital, in the aftermath of Hurricane Michael in Mexico Beach, Fla., Thursday, Oct. 18, 2018. At left is her mother, Amy Cross, and Amy's fiance, Corey Shuman. (AP Photo/Gerald Herbert) </p> <p> A man who did not want his name used receives medical treatment inside the Florida 5 Disaster Medical Assistance Team tent, outside the Bay Medical Sacred Heart hospital, in the aftermath of Hurricane Michael in Mexico Beach, Fla., Thursday, Oct. 18, 2018. (AP Photo/Gerald Herbert) </p> <p> A man who did not want his name used receives medical treatment inside the Florida 5 Disaster Medical Assistance Team tent, outside the Bay Medical Sacred Heart hospital, in the aftermath of Hurricane Michael in Mexico Beach, Fla., Thursday, Oct. 18, 2018. (AP Photo/Gerald Herbert) </p> <p> FILE - In this Oct. 14, 2018 file photo, Marla Wood pulls a framed art piece out of the rubble of her damaged home from Hurricane Michael in Mexico Beach, Fla. The tropical weather that turned into monster Hurricane Michael began as a relatively humble storm before rapidly blossoming into the most powerful cyclone ever to hit the Florida Panhandle, causing wrenching scenes of widespread destruction. (AP Photo/David Goldman, File) </p>

Credit: Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

icon to expand image

Credit: Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

GHA contains both rural hospitals struggling financially and wealthy hospital conglomerates expanding or sitting on millions of extra dollars. And GHA’s hard line against relaxing rules regulating cases has frustrated some key legislators.

Some lawmakers believe hospitals and health care businesses should be able to pick the cases they want in a free market. Many had tired of being lobbied so hard over the years and not being able to cut a compromise.