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November 20. 2012 3:33PM

Memorial Hospital trustees consider joining MaineHealth system

NORTH CONWAY - More than 200 community members showed up at the Red Jacket Monday evening to hear the CEO and trustees of Memorial Hospital explain why they think joining MaineHealth system is a good idea. For many in the audience, the issue is independence, and how much the local governing body will have, if the hospital becomes a subsidiary of the Portland-based not-for-profit healthcare system.

MaineHealth includes Maine Medical Center, 11 other hospitals, and other health-related organizations in Maine.

"We're really at the beginning of this process, not near the end," trustee chair Gene Bergoffen said. Though a letter of intent was signed, the details of a contract still have to be worked out, with due diligence and regulatory approvals expected to take about a year.

Memorial CEO Scott McKinnon said, "This is probably the most volatile time for health care in many, many years."

The trustees voted in October to pursue the affiliation, McKinnon said. MaineHealth was chosen because, besides being a decentralized system, the hospital and its providers have established relationships with health care providers in the Maine system.

Already, McKinnon said, 89 percent go to that system for specialty care.

"We see this as a huge advantage to working with MaineHealth," said McKinnon, who added changes in the way health providers will be reimbursed - with greater rewards for outcome than for quantity of services - will radically transform health care. Information flow - the "one patient, one record" model - preventive health care and integrated, vertical services, will be paramount. The goal is to keep costs down, while providing quality outcomes and increased access.

McKinnon said the affiliation steering committee has board members and providers on it.

Joining MaineHealth could provide the hospital with cost savings in legal, marketing, IT areas, along with better deals in purchasing medical equipment and supplies.

Two practitioners, Dr. Raymond Rabideau and Dr. David Riss, who have been in the Mount Washington Valley since the late 1970s, supported the relationship. Rabideau, who serves as an ex officio on the board, called it "the right choice."

McKinnon said the membership fee is based on a percentage, and would likely be around $250,000 a year. Though Memorial's trustees' role would remain much the same, MaineHealth would have ultimate power over budgeting, CEO hiring, and board appointments. How much the health care system would use that power remains uncertain.

McKinnon said committee members visited several hospitals in the system and heard positive feedback on MaineHealth's flexibility.

Memorial, McKinnon said, would still be financially independent, but since the Maine system is organized as a corporation, oversight is required. Memorial's charitable assets would stay in the community. The hospital could still partner with local providers, such as the White Mountain Community Health Center. Patients could also go outside the system for medical care.

"How do you cooperate up, if you don't cooperate down?" retired local doctor Donald Derse asked, referring to the hospital's relationship with a local independent medical center.

Former hospital trustee George Epstein, who recently resigned because of the proposed affiliation and wrote a column in a local newspaper outlining his concerns, maintained, "There are a whole lot of questions associated with this." He said that there should have been more of an effort to look at alternatives, stressing that the MaineHealth deal would make Memorial a wholly-owned subsidiary.

Dr. Jonathan Burroughs, who practiced at the hospital and is now a health care consultant, said Epstein was thinking of this as a business transaction, while he was viewing it as a health care transaction.

McKinnon said they would keep the community informed, with documents posted online, and that they plan to hold another public session to get more feedback.

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