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Urge to merge: Hospitals talk partnerships

KATHARINE SCHROEDER PHOTO Eastern Long Island Hospital in Greenport could soon become part of a larger hospital system.

KATHARINE SCHROEDER PHOTO
Eastern Long Island Hospital in Greenport could soon become part of a larger hospital system.

If a partnership agreement is inked between huge up-island facilities and the two East End hospitals, it’s obvious health care here will change.

The questions are how, and how much.

Some say it will be an administrative change only (see story, page 15), while others say patient care will improve.

For Eastern Long Island Hospital President and CEO Paul Connor, partnering with either Stony Brook University Hospital (SBUH) or the North Shore-LIJ Health System is inevitable, a response to the “evolving health needs of Shelter Island and the North Fork.” “Fee for service has reached its useful life” under the federal restructuring of health care services, Mr. Connor added. The movement today is about “population management and value.”

That’s the driving force his hospital and Riverhead’s Peconic Bay Medical Center are at the table for ongoing talks with the two large hospital systems that began this summer. It’s the same force that has had Southampton Hospital involved in talks for the past two years with Stony Brook.

The local hospitals are following national trends. According to the latest data from the American Hospital Association, the number of hospitals declined from 5,194 in 1995 to 5,008 in 2011. But the number of hospitals partnering up has increased — 15 years ago, 2,524 of American hospitals were part of systems; by 2009, that number was up to 2,921.

A QUESTION OF SURVIVAL
“Community hospitals like us” can’t survive without partnerships that involve aligning with academic medical centers, Mr. Connor said. The East End Health Alliance that was formed in 2008 to streamline services among ELIH, Southampton and the Peconic Bay Medical Center, making them complementary, more than competitive, and giving them more clout to negotiate with insurers and providers will “transition these hospitals into the next phase,” Mr. Connor said.

As is already happening, that next phase is seeing a shift from inpatient to outpatient care, Mr. Connor said. There’s an active effort to reduce readmissions that affect all hospitals’ reimbursements, he said.
“I don’t want to speculate, but we’d love to see all three [East End hospitals] able to go with the same system,” Mr. Connor said. At the same time, he said each of the three have an obligation to meet their specific needs. For ELIH, that’s to handle the evolving health care needs of Shelter Island and North Fork residents, including behavioral care for substance abuse and psychiatric services.

AGING OUT
ELIH serves an aging population. A quarter of its patients are on Medicare and that number is growing.

One example is the rapid expansion of the Peconic Landing Lifecare Community in Greenport, Mr. Connor said.

He doesn’t anticipate any radical changes for the next few years, no matter what the new alliance might bring, but noted that health care delivery is evolving. He predicted the alliance with either partner would provide the resources for more outreach and more “health literacy” within the community.

Pointing to the work being done with the hospital’s “Senior Options and Solutions” program, Mr. Connor said such outreach programs would be enhanced with a strong partnership.

As for patient care, it would continue to be provided locally unless services were required that don’t exist here. That has already been the case with the three area hospitals reaching out for services they can’t provide.

WIN WIN?
Both large hospitals have confirmed talks have been ongoing with ELIH and Peconic Bay through the summer.

Stony Brook is looking “to expand [its] existing relationships” with the two hospitals, said Dr. Reuven Pasternak, Stony Brook’s chief executive officer.

The two East End hospitals would “determine the time frame” of any negotiations, according to Terry Lynam, a spokesman for the North Shore-LIJ.

ELIH spokeswoman Eileen Solomon predicted movement could come during the first quarter of 2015.
Nassau County-based  North Shore-LIJ is the nation’s 14th largest healthcare system, comprising 17 hospitals and nearly 400 walk-in clinics and physician practices. It also has its own insurance company: North Shore-LIJ CareConnect Insurance Company, which is offered on the New York State of Health insurance marketplace, put in place by the Affordable Care Act.

“I think, in health care, the whole delivery model nationally is clearly changing,” Mr. Lynam said. “There is much greater focus on managing the overall health of an individual, as opposed to simply treating them when they get sick.”

The way to successfully work within that new model is to offer a wide-range of health services, including outpatient care such as nutrition and wellness, and critical care, such as emergency medicine, which happens through an in-patient hospital setting, Mr. Lynam said.

“The whole idea is to be able to improve care coordination,” he added. “As a health system, we offer this whole range of different services … and we are trying to keep all of the services within the network.”
If any of the community hospitals affiliate with SBUH, the partnership would allow Stony Brook to expand educational opportunities — including its residency program — since the hospital is a New York State educational corporation.

WORKING IT OUT
Southampton Hospital CEO Robert Chaloner described talks of an alliance with Stony Brook moving in a “positive” direction.

“Due diligence must take place in order for the partnership to be beneficial to both hospitals and to the community,” Mr. Chaloner said. “At this point, there are still a number of standard reviews that must be completed to ensure a strong alliance for the future.”

Of the Southampton partnership, a Stony Brook spokeswoman said in March, “A preliminary draft agreement has been prepared and is awaiting approval by the SUNY Board of Trustees. While we are optimistic about enhancing the affiliation, there has been no final agreement to date.”

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