Final Approval Given to Plan to Unite MaineHealth Members as a Single Not for Profit Organization
October 23, 2018
The Maine-based hospital members of MaineHealth will come together on Jan. 1, putting the strength of their entire system behind the care delivered in each and every community they serve.
Portland, Maine – Final approval was given today to a plan to bring together the members of Maine’s largest healthcare system as a single not-for-profit organization in an effort to put the strength of one of the region’s largest healthcare systems behind efforts to deliver care in each community.
The Corporators of MaineHealth, who are community representatives from across the system with a role overseeing the not-for-profit organization, voted at their annual meeting today in favor of a unification plan that has been under discussion for the past two years. The action means that, as of Jan. 1, Maine Medical Center, Southern Maine Health Care, LincolnHealth, Coastal Healthcare Alliance, Western Maine Health, Franklin Community Health Network and Maine Behavioral Healthcare will all be governed by a single Board of Trustees. However, each local organization will retain a local board that will have a significant role in overseeing the care delivered in each community.
The organizations oversee local health systems based in Portland, Biddeford, Norway, Farmington, Belfast, Rockport and Damariscotta as well as the Spring Harbor psychiatric hospital in Westbrook. These local organizations also include a range of physician practices and other healthcare facilities across an area serving 1.1 million people. The new, combined entity will have approximately 19,000 employees and more than $3 billion in annual revenues.
Memorial Hospital, a MaineHealth member in North Conway, N.H., is not unifying at this time because regulatory issues in New Hampshire put the process there on a different timeline. Also, two other current MaineHealth members, NorDx Laboratories and MaineHealth Care at Home, will not be unifying due to the unique scope of services they provide as non-hospital members.
“Getting all our local boards to agree on a plan that allows us to come together as one was not easy, but it was worthwhile,” said Susannah Swihart, chair of the MaineHealth Board of Trustees.
Two years ago, with many rural healthcare organizations in Maine struggling, MaineHealth members began a dialogue on how they could better leverage the strength of the whole system to make sure each community got the services it needed.
The inability to deploy resources across a system of free-standing member organizations had become a significant problem for community hospitals in recent years, as many came under increasing financial pressure because of changes in the way health care is being delivered.
Relatively simple procedures have been moving into outpatient settings, while complex care has been moving to regional medical centers that can afford new technologies used by highly specialized providers.
The result is that much of the revenue from surgeries and other procedures that sustained community hospitals in the past is no longer available to them, and many community providers are struggling. Those that aren’t losing money are typically small hospitals designated as “Critical Access Hospitals” by the federal government, which makes them eligible for more favorable Medicare reimbursement. However, their financial position has also recently eroded.
By bringing the members into a single organization, resources can now flow more easily between and among various parts of the healthcare system. That’s significant given that the MaineHealth system as a whole is financially strong, with the third best bond rating among New England healthcare systems, behind only Mass General’s Partners system and Yale New Haven Health.
Still, creating a single financial and operating model meant having one Board of Trustees, and that raised concerns about loss of local control.
The dialogue leading up to the decision to unify was extensive and public. Last year, MaineHealth held community forums in every community it serves. The forums were well attended, and the discussion was sometimes heated. Executive and volunteer leaders across the system worked to address the issue of local control by leaving in place local boards that would be committees of the larger Board of Trustees. Under the plan, these local boards have a considerable role in each community, participating in quality oversight, oversight of local medical staffs, planning, budgeting and the hiring of key executives, among other duties. Still, by bringing the members into a single organization, resources will now flow more easily between and among various parts of the healthcare system.
“But it’s more than just financial resources that can flow across the system,” said William Caron, President of MaineHealth. “Clinical and operational expertise will also flow more easily across the system. For example, unification will help us to address the shortage of physicians and other clinicians in rural areas by more easily sharing staff across the system.”
Significantly, unification will help MaineHealth build a system of integrated care, supported by a common electronic medical records system.
“We’ve already made great progress coordinating care in areas such as cardiac care, cancer care and stroke care,” said Joan Boomsma, senior vice president and chief medical officer of MaineHealth. “Unifying as one organization will make it easier for us to provide the best possible care as close to home as possible in every community we serve.”
MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and more than 1,500 employed and independent physicians working together through an Accountable Care Organization. With more than 19,000 employees, MaineHealth is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire. Members include Franklin Memorial Hospital/Franklin Community Health Network in Farmington, LincolnHealth in Damariscotta and Boothbay Harbor, Maine Behavioral Healthcare in South Portland, MaineHealth Care at Home in Saco, Maine Medical Center in Portland, Memorial Hospital in North Conway, N.H., NorDx in Scarborough, Pen Bay Medical Center and Waldo County Hospital in Rockport and Belfast, Southern Maine Health Care in Biddeford and Sanford, Spring Harbor Hospital in Westbrook and Stephens Memorial Hospital/Western Maine Health in Norway. MaineHealth Affiliates include MaineGeneral Health in Augusta and Waterville, Mid Coast Hospital in Brunswick, New England Rehabilitation Hospital in Portland and St. Mary's Regional Medical Center in Lewiston. MaineHealth is also a significant stakeholder in the MaineHealth Accountable Care Organization in Portland.