A dozen hospitals and health organizations in the state could unify as one nonprofit under a proposal being considered by MaineHealth.
Officials at the network say bringing together these current members as a single entity with a $2 billion budget could create a more stable health care system. But the proposal is also stoking fear among some hospitals that they will lose too much local control, to the detriment of patients.
This idea, to potentially unify MaineHealth’s members, has been simmering for years. But recent trends in the health care industry have brought the conversation to the forefront.
One hospital system that’s struggling under the changes is Southern Maine Health Care. President and CEO Ed McGeachey says specialized care is increasingly provided by larger hospitals, like Maine Medical Center.
“And so an awful lot of financial resources are going out of York County and to Portland,” he says.
It’s a national dynamic, says McGeachey, that puts community hospitals like his in precarious financial positions.
“And at some point, in order to sustain the services here in York County, some of that money that’s currently going into the Maine Medical Center, or the Portland system, really needs to come back to York County,” he says.
That’s what unification can do, says MaineHealth President Bill Caron. He says the current system, in which each member of the network operates as its own financial entity, has a downside.
“So that, if we have one hospital getting into financial difficulty because of volumes or payment trends, or other kinds of activities, and we see another hospital in the system doing well, it’s difficult, if not impossible, to transfer funds between those two organizations because they are separate corporate entities,” he says.
The result is that these smaller hospitals may be forced to reduce or cut services. But Caron says a unified model would ensure funding for an appropriate level of care throughout the network.
“That has the effect of not having a single community relying upon its own finances in a payment system that doesn’t work appropriately in many rural settings,” he says.
Caron stresses that the unified model is still in the beginning stages of discussion. There aren’t a lot of details, but unification would mean the creation of a single governing body — and that has raised concerns at some hospitals.
The medical staff at Waldo County General Hospital in Belfast voted unanimously in November against pursuing unification over fears that it would lose independence and be forced to defer to decision makers outside of the community.
At LincolnHealth in the midcoast, board member Les Fossel shares that concern.
“Top-down, centralized control generally doesn’t produce good grassroots results,” he says.
Fossel says LincolnHealth is in the black and performing well. It’s not clear to him that unification will benefit all MaineHealth members.
“Then I become very concerned that we don’t solve problems, we trade problems,” he says.
But LincolnHealth President and CEO Jim Donovan says it makes sense for MaineHealth’s members to at least explore the idea.
Discussions at member boards will take place through the spring, when it’s hoped that a consensus will be reached on whether to embrace or abandon unification.
