Hospitals everywhere, not just Memorial, on verge of major changes
Published Date
By Erik EiseleCONWAY — With hospitals everywhere on the verge of transformation, what will a revolutionized health care industry look like?
No one knows, but change is coming "because it has to," says the CEO of Memorial Hospital Scott McKinnon.
McKinnon is in the process of negotiating a deal with MaineHealth, the parent company of Maine Medical Center, that would make Memorial a MaineHealth subsidiary.
The proposal, which is still in the middle of a lengthy review process, is both a reflection of and in preparation for the changes taking place within the health care industry.
"A lot of other hospitals and providers in the state are having similar discussions," McKinnon said.
Indeed in November the state's two largest health care organizations — Dartmouth-Hitchcock and the Elliot Health System — announced they were engaged in a "good-faith dialogue" on collaboration, and Southern New Hampshire Medical Center in Nashua announced an agreement with Massachusetts General Hospital to affiliate their pediatric, oncology, digestive health, surgery and cardiovascular services.
Those announcements follow last summer, when three North Country hospitals — Androscoggin Valley Hospital in Berlin, Weeks Medical Center in Lancaster and Upper Connecticut Valley Hospital in Colebrook — announced they are going to enter a collaborative partnership to "provide greater access, quality and affordability in the delivery of health care services to the people of Coos County."
In all cases hospital officials talked about the necessity of such arrangements to ensuring quality care at an affordable price in a changing health care environment.
"Our collaboration will create a whole that is greater than the sum of its parts," Scott Howe, CEO of Weeks Medical Center, said when the North Country partnership was announced back in July. "We believe we can keep quality care here at home in Coos County where it belongs — close to the patients we serve."
Officials from other hospitals stress similar points.
"We saw it as a way to meet the needs of the community," said Andrea Alley, a spokesman for Southern New Hampshire Medical Center. Partnering with Massachusetts General will make it possible to provide Boston-level care in Nashua, she said. "It's a result of us looking at how we can continue to serve patients in the best way possible," she said. "It's making the care more accessible."
"We understand that health care is not perfect," she said, and everyone is looking for the best way to improve care. "Sometimes collaborations are the best way to do it."
The problems, however, are better understood than the solutions. Reform needs to happen, McKinnon said, to address rising costs, to improve access for un- and underinsured, and to ensure better outcomes. "In the future providers are not going to be paid by how many CT scans they do," he said, but by the quality of the care they provide, the fewer full beds the better.
But McKinnon and other health care officials know the system changing. Providers at every level have been been squeezed by cost pressures, and everyone agree access and outcomes need to improve. No one knows, however, the shortest path to get the system from where it is to where it is going. Different organizations are taking different steps to address the coming changes — Dartmouth-Hitchcock and the Elliot Health System, for example, are not considering a merger, acquisition or takeover, the way MaineHealth and Memorial Hospital are.
They are, however, looking to solve the same problem.
"We're focused on the reality that health care costs are getting out of the realm of affordability for state government, federal government and the business community," Elliot Health System president and CEO Douglas Dean told the Union Leader when the talks first became public.
The challenges don't discriminate between hospitals big or small, urban or rural, wealthy community or poor — everyone is talking cost, quality and access.
"Our goal is to improve the quality of care available and maintain costs which can be sustained by businesses and individual patients in an economically challenged area," said Mark Kelley, chairman of the board at Androscoggin Valley Hospital.
"The world of health care is changing quickly," said Winston Young, chairman at Upper Connecticut Valley Hospital. "Clearly we can do this far more effectively by collaborating than by attempting to go it alone."
Coordination of care between hospitals, clinics and other providers improve efficiency and quality, McKinnon said, but the trick is figuring out the best way to do that. The new health care law will create something called an accountable care organization to do just that, he said, but "it's at the infancy stage right now."
In Massachusetts, meanwhile, he said, mandating health coverage reduced the percentage of uninsured patients to the single digits, but costs went up. "Is the same thing going to happen," he said, now that a similar law has been past nationally? And "What does that mean in terms of access to care?" he said. "Is there going to be a surge in demand?"
Those questions and more are still on the horizon. The future, both locally and nationally, is incredibly uncertain.
"What are we doing to prepare for this?" McKinnon said. A lot, from improving the patient experience to working on community health to ensuring financial viability. "We can't continue in this same model into the future," he said. It just isn't sustainable.
Memorial is not just in talks with MaineHealth, he said. The hospital also collaborates with the North Country hospitals, the White Mountain Community Health Center and others. "We will continue to explore these opportunities," no matter what happens with MaineHealth.
The proposal, which is still in the middle of a lengthy review process, is both a reflection of and in preparation for the changes taking place within the health care industry.
"A lot of other hospitals and providers in the state are having similar discussions," McKinnon said.
Indeed in November the state's two largest health care organizations — Dartmouth-Hitchcock and the Elliot Health System — announced they were engaged in a "good-faith dialogue" on collaboration, and Southern New Hampshire Medical Center in Nashua announced an agreement with Massachusetts General Hospital to affiliate their pediatric, oncology, digestive health, surgery and cardiovascular services.
Those announcements follow last summer, when three North Country hospitals — Androscoggin Valley Hospital in Berlin, Weeks Medical Center in Lancaster and Upper Connecticut Valley Hospital in Colebrook — announced they are going to enter a collaborative partnership to "provide greater access, quality and affordability in the delivery of health care services to the people of Coos County."
In all cases hospital officials talked about the necessity of such arrangements to ensuring quality care at an affordable price in a changing health care environment.
"Our collaboration will create a whole that is greater than the sum of its parts," Scott Howe, CEO of Weeks Medical Center, said when the North Country partnership was announced back in July. "We believe we can keep quality care here at home in Coos County where it belongs — close to the patients we serve."
Officials from other hospitals stress similar points.
"We saw it as a way to meet the needs of the community," said Andrea Alley, a spokesman for Southern New Hampshire Medical Center. Partnering with Massachusetts General will make it possible to provide Boston-level care in Nashua, she said. "It's a result of us looking at how we can continue to serve patients in the best way possible," she said. "It's making the care more accessible."
"We understand that health care is not perfect," she said, and everyone is looking for the best way to improve care. "Sometimes collaborations are the best way to do it."
The problems, however, are better understood than the solutions. Reform needs to happen, McKinnon said, to address rising costs, to improve access for un- and underinsured, and to ensure better outcomes. "In the future providers are not going to be paid by how many CT scans they do," he said, but by the quality of the care they provide, the fewer full beds the better.
But McKinnon and other health care officials know the system changing. Providers at every level have been been squeezed by cost pressures, and everyone agree access and outcomes need to improve. No one knows, however, the shortest path to get the system from where it is to where it is going. Different organizations are taking different steps to address the coming changes — Dartmouth-Hitchcock and the Elliot Health System, for example, are not considering a merger, acquisition or takeover, the way MaineHealth and Memorial Hospital are.
They are, however, looking to solve the same problem.
"We're focused on the reality that health care costs are getting out of the realm of affordability for state government, federal government and the business community," Elliot Health System president and CEO Douglas Dean told the Union Leader when the talks first became public.
The challenges don't discriminate between hospitals big or small, urban or rural, wealthy community or poor — everyone is talking cost, quality and access.
"Our goal is to improve the quality of care available and maintain costs which can be sustained by businesses and individual patients in an economically challenged area," said Mark Kelley, chairman of the board at Androscoggin Valley Hospital.
"The world of health care is changing quickly," said Winston Young, chairman at Upper Connecticut Valley Hospital. "Clearly we can do this far more effectively by collaborating than by attempting to go it alone."
Coordination of care between hospitals, clinics and other providers improve efficiency and quality, McKinnon said, but the trick is figuring out the best way to do that. The new health care law will create something called an accountable care organization to do just that, he said, but "it's at the infancy stage right now."
In Massachusetts, meanwhile, he said, mandating health coverage reduced the percentage of uninsured patients to the single digits, but costs went up. "Is the same thing going to happen," he said, now that a similar law has been past nationally? And "What does that mean in terms of access to care?" he said. "Is there going to be a surge in demand?"
Those questions and more are still on the horizon. The future, both locally and nationally, is incredibly uncertain.
"What are we doing to prepare for this?" McKinnon said. A lot, from improving the patient experience to working on community health to ensuring financial viability. "We can't continue in this same model into the future," he said. It just isn't sustainable.
Memorial is not just in talks with MaineHealth, he said. The hospital also collaborates with the North Country hospitals, the White Mountain Community Health Center and others. "We will continue to explore these opportunities," no matter what happens with MaineHealth.
