Published: October 08, 2008 04:00 am         

Hospitals to talk cooperation

A.O. Fox Memorial Hospital and Bassett Healthcare officials said Tuesday they will discuss new ways to provide health care to area residents.

No meetings have been held, and officials said the talks will focus on cooperation between the institutions, not a merger, buyout or corporate link. The talks are motivated by a desire to better serve patients near their homes, not to seek cost savings, an official with each organization said.

The Fox board of directors unanimously decided at its September meeting that it made sense to talk with Bassett about possible areas of cooperation in clinical services, said John Remillard, Fox president and chief executive officer. Challenges, including a physician shortage, government reimbursement rates and a growing number of uninsured patients, prompted revisiting talks, which could identify improved ways to meet patient needs, he said Tuesday.

``We're going to look to have a cooperative relationship with Bassett and its doctors for certain groups of patients,'' Remillard said.

However, he added, he was reluctant to be more specific about the clinical areas until hospital representatives had a chance ``to meet face to face.''

The Fox medical staff, which previously opposed any link with Bassett, voted last month in favor of initiating talks, said Dr. Benjamin Friedell, a physician with Oneonta Family Practice and a Fox employee. The majority of physicians on the Fox medical staff are employees of the hospital, Friedell said. That, he added, is a significant change since he started at Fox 24 years ago, when most were in private practice.

``There has become less and less resistance on the part of the medical staff to shared medical services with Bassett,'' Friedell said Tuesday.

Nationally and locally, fewer physicians want to enter private practice because of the costs, he said, and physician recruiting to area hospitals is difficult, especially in specialized areas such as orthopedics and oncology, where there is a duplication of services.

The economy has become increasingly hostile to standalone hospitals, said William Van Slyke, spokesman for the Healthcare Association of New York State, which represents more than 550 hospitals, nursing homes and other health-care organizations. Medicare and Medicaid reimbursements decline each year and expenses rise, he said, even as private insurers are also paying less. In addition, the field faces a shortage of nurses and physicians, plus higher technology costs.

To meet community needs, an organization must be solvent and viable, Van Slyke said. Hospitals across the state increasingly have been finding ways to share services, merge and create links to meet the challenges.

``Avoiding duplication and meeting community needs is really the future of health care,'' Van Slyke said.

In the past 15 years, discussions between Bassett and Fox were opposed by the Fox medical staff.

``Bassett has always been open to opportunities to work together with Fox,'' said Dr. Steven Heneghan, chief of surgery, who has been involved with the latest possibility of negotiations.

``We are really, honestly describing these as very preliminary,'' he said Tuesday.

Reasons to support talks include gasoline prices faced by patients, Heneghan said, and physician-recruiting challenges faced by Bassett, in addition to economic stress and changes in the health-care industry. The motivation is better service to patients rather than saving on costs, he said, and each organization would maintain its identity.

None of the talks would be about affiliating, merging, combining entities or constructing buildings, Heneghan said. And it's too early to say which services might be shared, he said.

Heneghan spoke for Bassett on behalf of president and CEO Dr. William F. Streck, who is traveling.

Meeting could be in November

Fox has about 100 acute-care beds, 130 nursing home beds and about 1,000 employees, officials said. Of about 70 physicians with privileges to practice at Fox, about 40 are employed by the hospital and 30 are in private practice.

Bassett Healthcare employees 230 physicians. The Bassett network has 25 clinics and four affiliated hospitals; Mary Imogene Bassett Hospital in Cooperstown is a teaching hospital with 180 beds.

Remillard said he hoped a meeting among representatives from the two institutions could be arranged for November. As for results _ such as some Bassett physicians working with Fox _ Remillard said he was hopeful for late this year or early next year. No layoffs are expected.

Fox is struggling to generate revenues to meet its $82 million annual budget, Remillard said. Financial savings are possible in a cooperative situation and are a consideration, but they aren't a driving factor in implementing talks, he said.

A recent development affecting revenues has been the postponement of care by patients facing personal economic hurdles, he said.

Fox's 10-year affiliation with Albany Medical Center remains, said Remillard. His colleagues there have been informed about the pending talks. Long-term ties with the center haven't been addressed, he said.

The talks will include doctors and other major stakeholders from Fox, but will be ``small enough to be nimble,'' Remillard said.

The Fox board of directors adopted a strategic plan earlier this year that identifies five areas to be address, Remillard said. The areas are: physician recruitment, information technology, delivery of quality care, rebuilding the physical infrastructure and having a strong financial position.

Conversations with Bassett, he added, could help Fox find ways to fulfill its strategic plan.

Possible links with Bassett Healthcare, based in Cooperstown, have been on and off the table at A.O. Fox Memorial Hospital in Oneonta. Some possibilities were:

March 1994: Fox and Bassett were studying a plan that recommended merging. Fox medical staff called for a halt to talks because of concerns that the plan would allow Bassett to take over the Oneonta hospital.

March 17, 1994: The Fox board of directors voted to postpone discussions with Bassett Healthcare while an independent consultant reviewed Fox's options.

June 1995: Fox released a strategic plan that focused on competing with Bassett instead of merging.

1997: Fox considered affiliations with Bassett, United Health Services and Albany Medical Center. UHS in Binghamton withdrew from consideration.

September 1997: Fox medical staff conceded that the hospital would have to affiliate with another provider, but the staff didn't want the potential provider to be Bassett. The staff supported affiliating with Albany Medical Center.

1998: Fox affiliates with Albany Medical Center.