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MaineHealth says unification talks are in very early stages

Doctors fear loss of local control with proposed merger plan

By Stephen Betts | Dec 02, 2016
Photo by: Stephen Betts Lee Woodward Jr., president of the Coastal Healthcare Alliance Board of Directors, spoke last week at the annual meeting of an advisory group of the organization that oversees Pen Bay Medical Center and Waldo County General Hospital. The board meets Tuesday, Dec. 6, at which time a letter from doctors at Waldo County may be discussed.

Rockport — Doctors at one Midcoast hospital are united in opposition to a proposal to create a single statewide board to make decisions for several Maine hospitals, including Pen Bay Medical Center and Waldo County General Hospital.

Officials from MaineHealth, the parent corporation of the region's health care providers, maintain, however, that the concerns are based on a desire for more information on what is being contemplated and discussions are in a very early stage. The president of MaineHealth will be visiting the medical staffs at the hospitals over the next few weeks to answer questions.

But MaineHealth maintains the change is needed.

"The rapidly changing industry landscape is forcing the conversation about governance and operating model unification across MaineHealth sooner than many of us had anticipated," according to a paper issued by MaineHealth to physicians. "These trends are proving highly disruptive for our members and threaten to undermine our efforts to provide excellent, patient-centered care."

The merger would create a single, $2 billion organization with 18,000 employees.

The medical staff at Waldo County General in Belfast, however, voted unanimously Nov. 15 to urge its local hospital board to vote against the MaineHealth proposal.

"We fear that further loss of the independence of our hospital will lead to decisions by others who are not a part of, nor equally concerned about our community as those of us who live and work here- and that 'something special' will be lost," the letter from the Waldo County doctors states.

"We are concerned that a geographically remote and diverse Board cannot make the same well informed decisions about staffing, services, finances and appointments for our hospital and community that our current local Board can. What affect will unification have on our charitable contributions and endowment? Community involvement? Staff engagement? There are many other very important questions, about which we don’t even know enough to ask, for we have so little knowledge of the details of the proposed agreement," the letter states.

The physicians have urged the Coastal Healthcare Alliance Board, at this time, "to not approve of or proceed with the current proposed agreement for further amalgamation with Maine Health."

Coastal Healthcare Alliance is the board that oversees PBMC and Waldo County General as well as MaineHealth Care at Home (the former Kno-Wal-Lin home health care), Knox Center for Long Term Care, Quarry Hill, Sussman House, and nearly all the local physician practices.

Coastal Healthcare is a member of MaineHealth, whose largest member is Maine Medical Center in Portland. Other hospitals that are part of organizations that are members of Maine Health include the Miles Campus hospital in Damariscotta, the St. Andrews Campus medical facility in Boothbay Harbor; Franklin Memorial Hospital in Farmington, Southern Maine Medical Center in Biddeford and Stephens Memorial Hospital in Norway.

Pen Bay became a member of MaineHealth in 2012 after incorporators -- citizens from the community -- voted 143 to 6 to approve the partnership. There was considerable discussion at that meeting on whether local control of health care decisions would be lost.

The agreement approved in 2012 required certain major decisions by Pen Bay to also be approved by the MaineHealth board. Those included adoption of annual and capital budgets; strategic plans; incurring any debt in excess of $500,000; a sale, purchase, lease, transfer or mortgage in excess of $500,000; adding or eliminating programs; hiring, firing or evaluation of the chief executive officer; and election of Pen Bay Healthcare board members.

But the agreement also stipulated that no service offered locally could be discontinued unless initiated and approved by the local board.

Waldo County became a MaineHealth member in 2009.

Pen Bay and Waldo County boards merged in 2015 into a single organization called Coastal Healthcare Alliance, which remains a member of MaineHealth. The two regional hospitals have significantly increased sharing of physicians and services since that change.

The Waldo County physicians acknowledged in their November letter that "there are economic and political forces at play which threaten our long-term viability, and we also recognize the value of keeping all the MH hospitals open and thriving, we need to forge an agreement that is healthy for all and which will afford each hospital system the ability to preserve that which is most important to our local communities."

The doctors questioned whether this was the right time for "such another large change."

"We are still working through our recent alliance with Pen Bay and the changes that have come with that. We continue to digest the challenges brought to us by the EPIC implementation," the doctors stated.

EPIC is a new information technology system being installed to share medical records.

"Therefore, we urge all the members of the CHA Board to take their time and carefully consider this proposal of ‘Unification’. To also allow the medical staff and community the opportunity to become well-informed and to make comments and suggestions. This is a momentous decision. There is no rush. Our Board and our community may not have another equal opportunity to determine the future of our hospital," the doctors concluded in their letter.

Dr. Benjamin Mailloux, the president of the approximately 42-member Waldo County medical staff, said Thursday, Dec. 1, the vote was a bold statement for the Coastal Board to think long and hard before taking a vote at this point.

Mailloux said the doctors at the hospital are already dealing with the departure later this month of longtime President and Chief Executive Officer Mark Biscone and the merger with Pen Bay, which led to their decision to issue the letter.

William Caron, the president and chief executive officer of MaineHealth, is scheduled to meet Tuesday evening, Dec. 6, with the medical staff at Waldo County. A similar meeting is scheduled for Dec. 15 with the Pen Bay physicians.

The Nov. 15 vote by the Waldo County physicians followed an Oct. 22 letter to the medical staffs at Waldo County and Pen Bay from Biscone.

"With the pace of change accelerating within the health care industry, it is again time to foster a dialogue about our governance and operating models to ensure MaineHealth and its members can deliver excellent care, contain costs and promote health and wellness in our communities – all key elements to delivering both our vision and mission," Biscone stated.

Biscone said several committees will be created to review the proposals, a process that is expected to take six months.

Biscone said unification would mean a single MaineHealth budget and balance sheet and a single board that would "govern the system in a way more nimble than our current structure."

He said it would not mean the loss of local identity and local medical staff structure. The makeup of the new single board has not been detailed, or how much representation each region would have on the board.

"It does not mean backing away from giving our patients excellent primary and appropriate secondary care in their communities. It does not mean ceasing to do locally those things that make sense locally.

"It does not mean that each local area will not be accountable to deliver against local and system objectives. It does not mean that more changes won't be required to meet our goals," Biscone said.

Telephone messages were left Thursday morning with the presidents of the medical staff at Pen Bay, Franklin Memorial and Stephens Memorial to determine what the physicians at those hospitals think of the MaineHealth proposal. MaineHealth Marketing and Communications Director John Porter said all inquiries are to be channeled to him for consistency's sake. He said Waldo County was the only medical staff to respond to the proposal, noting that the discussions are in an early stage.

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Comments (6)
Posted by: Stephen Betts | Dec 03, 2016 11:10

As General Sherman once said "I will not accept if nominated and will not serve if elected."

Posted by: Kenneth W Hall | Dec 03, 2016 10:56

The "non profit" corporation is for the 503c correct?

The local control is still gone and the prices are still determined beyond the local market.  DO NOT be fooled by the "non-profit" veil.  The administrative executives still draw large salaries as well as bonuses.  The "non-profit" veil is to avoid paying taxes to the government.  Some call it "an accounting loop hole"


So read carefully with the rose colored glasses in the term "non-profit"

Maybe there should be a Stephen Betts Foundation.   It can be started with the President Stephen Betts making $1,000,000 per year in salary and still have the foundation be a "non profit".  If the president of the corporation does not loose money the extra monies go into the "golden parachute" fund when President Betts decides to retire.

Posted by: Stephen Betts | Dec 02, 2016 19:27

MaineHealth is a non-profit corporation.

Posted by: Kenneth W Hall | Dec 02, 2016 17:58

The doctors are right.  "Boards" from away make decisions based of cost benefits and profits.

Do you really think a "Board" is going to sacrifice profits for quality of care?  Be honest!!  Have a peak what is in the future----

Posted by: Mary A McKeever | Dec 02, 2016 16:57

Corporations replaced the oneness of each towns' OWN hospital. Each town was proud of their hospital. Now Corporations replace boards filled with neighbors. Simplicity and common sense ruled. Paid Boards prevail and the common good suffers, perhaps?

Posted by: Kathryn Fogg | Dec 02, 2016 10:49

A lot of questions before the corporate gobble up.


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