One month from tomorrow will mark the 110th anniversary of the Eastern Long Island Hospital Association’s first meeting. An all-volunteer organization at the time, the precursor to the hospital’s current board of directors gathered in 1905 to establish the building blocks of a community hospital.
At the time, various committees were formed, including one tasked with exploring how to convert the hospital — originally housed in a former residence — into a place where people could come for health care services.
More than a century later, Eastern Long Island Hospital in Greenport is on the verge of joining one of Long Island’s largest health care systems. Its Board of Directors voted unanimously July 9 to begin the process of affiliating with Stony Brook University Hospital, merging the small, rural facility with an organization that boasts a $1.1 billion annual budget and hosts Suffolk County’s only level-one trauma center and academic medical center.
“It was not a tough call to make,” said ELIH Board Chairman Thomas Murray. “At least, in the final weeks it wasn’t.”
ELIH’s decision to merge with Stony Brook comes months after Riverhead’s Peconic Bay Medical Center voted to start its own process of joining North Shore-Long Island Jewish Health System, one of the nation’s largest health organizations, and about six months after Southampton Hospital also voted to affiliate with Stony Brook.
Although ELIH was the last of the three East End hospitals to enter into an agreement with a larger organization, it had been in negotiations with both SBU and North Shore-LIJ for years.
The move comes at a time when, according to Harvard Medical School, “all across America, hospitals are merging.”
An annual report on hospital mergers and acquisitions compiled by health care research group Irving Levin Associates shows that the volume of hospital deals rose by 14 percent in 2014 over the previous year.
That growth, the study remarked, “reflected the growing impact of the Affordable Care Act, and the shift in reimbursement models, toward value-based payments.”
On the East End and elsewhere across the nation, that trend has left smaller hospitals unable to leverage the reimbursement rates from insurance companies they once could.
“ELIH doesn’t have the size or revenue base” to get the reimbursement rates that larger health systems get, said its CEO and president, Paul Connor. “So we need to join an entity that has the financial resources.”
In an interview, those involved with the merger noted that a number of valuable services can now be brought to ELIH while maintaining the community feel of which the Greenport facility is so proud.
“We can provide significant support from the staff at Stony Brook University. In areas such as information systems — which is something so critical to hospitals right now — we can do things at considerably lesser costs than if they were to do it themselves,” said SBU’s CEO Dr. Reuven Pasternak, who is also vice president of health systems. “The same applies to compliance, finance — all of the regulatory functions in which hospitals now have to operate have gotten incredibly complex and well beyond the scope of what a smaller institution used to be able to do. That’s something we can bring together as a combined entity.”
Administrative services aside, Dr. Pasternak pointed out that affiliation with a larger entity will also permit the expansion of medical services at ELIH, including vascular procedures, oncology, general surgery, urology, neurosurgery, gynecological surgery and behavioral health.
“Let’s bring the patient care to the patient,” said Dr. Ken Kaushansky, dean of the SBU School of Medicine and senior vice president of health sciences. “If we have a procedure that can be perfectly well done at ELIH — if they need a specialist who can do the procedure there and the patient can feel more comfortable close to home — that’s terrific.”
Gregory Garrett, executive vice president at Peconic Landing in Greenport, said he’s “looking forward to the services Stony Brook can provide the community.” Peconic Landing itself is in the process of a $45 million expansion that will include a new memory care facility and acute rehabilitation unit.
“Both of those areas, I feel, could be a great opportunity for our organization and a research institution like Stony Brook University,” Mr. Garrett said.
Neither Mr. Connor nor Mr. Murray would specify what tipped the scales in SBU’s favor, but both offered praise for North Shore-LIJ with which ELIH nearly partnered 12 years ago. At that time, both Mr. Connor and Andrew Mitchell, CEO of PBMC, supported joining the same parent network.
But the health care industry has changed since then.
In 2006, the state’s Berger Commission report recommended that five of Suffolk County’s easternmost hospitals gather under the Stony Brook umbrella and that the sixth, St. Charles Hospital in Port Jefferson, run by Catholic Health Services, be closed. Although that never occurred, the report noted that if those hospitals were to “come together with the University Hospital, their strength and more importantly, their long-term viability increases exponentially rather than in an additive manner.”
Following the Berger Commission report, ELIH, PMBC and Southampton Hospital formed the East End Health Alliance. But the Affordable Care Act — better known as Obamacare — has “made the effort toward focusing on the patient and the facility around the patient rather than the patient around the system,” said Mr. Connor.
Mergers have since ensued nationwide and the EEHA is being officially dissolved.
Stony Brook University Hospital and ELIH will now develop a “definitive agreement” that will lay out all the legal obligations each organization has to the other.
While that accord is being finalized, the facilities are already moving forward together on the North Fork.
According to Dr. Pasternak, the hospitals are considering the establishment of operations in Mattituck to complement those in Greenport and Riverhead. In addition, Stony Brook hopes to bring primary care physicians who aren’t currently affiliated with the organization under its umbrella.
“This is part of an East End strategy we have long planned on doing,” Dr. Pasternak said. “We’re going to continue to execute it, now with more focus.”
Following ELIH’s merger decision, only two Suffolk County hospitals — Brookhaven in East Patchogue and Mather in Port Jefferson — remain unaffiliated with larger health care organizations.