Hospital collaboration

Hudson Health Partners provided this model of the continuum of care which seeks to explain the different roles of various kinds of health care providers.

Beset by competitive pressures on all sides, some community hospitals are considering desperate measures. Used to struggling fiercely for local market share with each other and increasingly beset by other problems, hospital systems in the Hudson Valley are adopting strategies that a few years ago would have been unthinkable. In some cases, they’re even cooperating with each other.

Three mid-Hudson hospital systems last week announced the formation of a new collaboration through which they can work together to seek efficiencies of operation and to control costs. Hudson Health Partners LLC was described by its chairman, Allan Atzrott, also CEO of the two-campus St. Luke’s Cornwall Hospital, as “a true partnership.” It consists of St. Luke’s in Newburgh and Cornwall, St. Francis Hospital in Poughkeepsie and Beacon, and the Bon Secours hospital system, consisting of Bon Secours in Port Jervis, Good Samaritan in Suffern and St. Anthony’s in Warwick. The three systems have equal shares in the new corporation, said Atzrott.

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The collaboration may grow to include other hospital systems. Atzrott said conversations have already been held with five additional potential partners.

The arrangement is a strategic alliance, not a merger. Each hospital will remain independent under the control of its own governing board.

A press release describing Hudson Health Partners delineated five broad areas for the collaboration. One focus was quality initiatives and best practices. Clinical collaboration, including wellness initiatives, pre- and post-hospital care, and expansion along the continuum of care, was a second. Physician services will include such significant items for collaboration as recruitment, medical education, integration of health records, and services for practice management. Cooperation in the areas of hospital services, employee benefits, pilot projects and support services will be encouraged. Finally, group purchasing and the sharing of general services will be pursued.

Jeanine Logan, spokesperson for the Northern Metropolitan Hospital Association (Normet), the regional hospital trade group, said the move would be a good thing. “Any collaboration that will help patient care, help improve physician recruitment, and do other such things could be helpful,” she said.

Fewer inpatient stays

Average in-hospital stays, said Atzrott, used to be nine days. Now it’s four — and dropping. Eighty-five percent of service used to be inpatient and 15 percent outpatient. Now the ratio is 60 percent to 40 percent, he continued, and shifting more to outpatient every year. Some 60 percent of ambulatory surgeries are now performed outside hospitals. “Forty percent of something is better than 100 percent of nothing,” noted Atzrott.

The direction of change is the same as that cited by HealthAlliance officials at the recent community forums in Ulster County. HealthAlliance CEO David Lundquist has said that he doesn’t expect the diminution of volume experienced by hospitals during the present recession ever fully to be reversed. New patterns of relationships, for instance one in which the hospital provides the space and other providers the services, are likely. In some cases, one hospital will provide specialized services for the communities of other hospitals.

“Integrating consolidations with other institutions is important,” Lundquist said at a recent forum at Benedictine Hospital. “We are fully integrated with other providers. We cannot be a standalone in this world.”

The state and regional health insurance exchanges created in New York State this year under federal legislation are intended to promote and measure patient-centered care. It is hoped they will provide a continuum-of-care scenario through which the different players will sort out their roles in a more cost-aware, efficient health care environment.

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