University of Louisville’s Dream Partner?
A notice in yesterday’s Courier-Journal announced that the Baptist Healthcare System was changing its name to Baptist Health as it acquires the Pattie A. Clay Hospital in Richmond KY. The shorter name is a little punchier and more touchy-feely: this in keeping with the hospital system’s warm and fuzzy marketing themes. Why not?
What I had been overlooking this past year was Baptist’s expansion of influence throughout the state. If all goes as seems planned, Baptist will finalize a full acquisition in October of the Madisonville Regional Medical Center and Trover Clinic, all soon to become Trover Health. This is a prestigious high-quality acquisition for Baptist Health and I congratulate them. Baptist now has mainline hospitals in cities across the entire state including Paducah, Madisonville, Elizabethtown, Louisville, La Grange, Lexington, and Richmond. In fact, I am unaware of any other hospital system in Kentucky so well represented statewide.
Possible Partner for UofL?
If all the University of Louisville was looking for was a clinical partner with which to establish an accountable care organization, a statewide clinical referral network, or additional sites in which to train physicians, Baptist would have to be at the top of the list. Both KentuckyOne Health and the University of Kentucky are both focused in eastern Kentucky where UofL would be perceived as an interloper. KentuckyOne Health is having financial and other problems of its own. UofL and UK do not have a great tradition of cooperation on which to draw.
I had heard early on in our local search-saga that Baptist had flatly rejected an overture from UofL. If the University was smart, it would not give up so easily. Perhaps we will all be surprised next month when the covers come off the Baptist/Trover agreement. After all, UofL has been stalling its way into this Fall from making any announcements of its own. However, if all the University wanted was better clinical integration with the rest of the Louisville medical community, it should not be contemplating entering exclusive agreements that will automatically force patients and their doctors to choose sides.
Academic Affiliation Agreement With Trover Health?
Whether or not the University of Louisville Hospital is included in any way in the expanded Baptist system, the University of Louisville itself will have to be. For many years, the Trover Clinic and its affiliated hospital have been major teaching partners for the medical school. Indeed, that teaching affiliation was the centerpiece of UofL’s demonstrable commitment to training its students in a rural setting. It is not an overstatement to say that a continuing relationship is of great importance to the medical school’s accreditation. The all-controlling academic affiliation agreement between the two institutions is going to have to be rewritten. I wish I could see it.
Clinical Capacity Not the Only Goal.
However we all know that simply expanding University of Louisville Hospital’s clinical reach was not the only goal, nor indeed a major goal of the University’s quest for a new owner. Millions of dollars were supposed to flow into the coffers of its commercial research enterprise. While Jewish hospital was once a willing partner in those sorts of endeavors, I would be surprised to see Baptist Health moving in that direction. In my opinion, emphasizing research as it did was not helpful to Jewish Hospital in the long run and diverted its attention from more important hospital operations. Frankly, I think a failure to keep its priorities straight is what has also brought University Hospital to its self-described knees.
Hospital and Doctor Wars Only Going to Get Worse.
There is an extraordinary push nationally to form bigger and bigger hospital-based networks of healthcare providers. The most socially acceptable justification for these mergers and partnerships is to form “accountable care organizations” in which to provide maximally coordinated care using the best medical and administrative practices to provide the safest and most effective medical treatment. In the real world, a major goal is to become the “elephant in the room” in order to be able to call the shots in financial relationships with medical insurers or with the government. (For example, this is what has finally forced the private practices of the University faculty together to act as one, not so the University can direct them to practice at University Hospital where they are badly needed.) We have seen how this struggle of giants is playing out in Kentucky with one hospital system or doctors group or another refusing to contract with Medicaid, or Humana, or Anthem to the detriment of us patients who are only hoping for some modicum of medical care upon which we can rely and afford. Alas, I do not see that modest vision happening soon, do you?
Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
10 September 2012