Each meeting began with my introduction of Dr. McCabe, who is not known to most employees.
Dr. McCabe briefly reviewed his background, and he talked about his philosophy of hospital management: to employ capable people and to provide the resources to help them do their jobs. He acknowledged the technical and professional expertise of hospital employees. He said he understands and appreciates that patient care depends on each individual’s competence and caring.I told employees who attended the meetings that Dr. McCabe and I have worked closely together throughout the summer and fall, and we have developed mutual confidence and respect.
I briefly reviewed the reasons why Community is interested in combining with Upstate University Hospital as referenced in comments about discussions with Upstate and buying medical practices.
I reviewed some of changes that are expected to affect hospitals and doctors, and I reminded employees about the areas our Board of Directors has determined to be important: the need for future investment in facilities and medical technology, the need for more options and opportunities to work with physicians, and the need for larger scale operations to achieve greater efficiencies and access to resources.
I said that Community's Board is interested in the future role of the hospital in providing quality care to the populations we have traditionally served through emergency, inpatient and outpatient services. Community’s goal is to build upon the traditional assets developed over decades, namely, the private medical staff, the skilled work force, and the property, plant, and equipment.
Dr. McCabe said that Upstate has similar and complementary goals. Upstate has a very high occupancy rate, upwards of 90% -- and Upstate is growing. As a result, Upstate needs more acute care beds, and Community has acute care capacity. The ways in which Community’s physical infrastructure and its licensed capacity can help address Upstate’s growing needs are being actively explored. He said the goal is to have a single hospital with two campuses.
Upstate’s educational role will expand in the future as more physicians, midlevel practitioners, and allied health professionals are needed. The Community campus would maintain a separate identity within the Upstate system and would participate in Upstate’s academic role. The extent of educational involvement would vary, depending on the clinical service and the interest of private practice physicians and health practitioners.
Dr. McCabe said Upstate recognizes the role and importance of the private, voluntary medical staff at Community and seeks to foster such private practice. In areas where services can be improved by a combination of private staff and university physicians, Upstate is willing to cooperate – examples include the current hospitalist service and cardiology coverage. If private practice is not able to provide a service, Upstate would do so (for example, intensivist services).
How to bring together the two medical staffs has not yet been determined, and initial meetings have been held with Community physicians to begin considering the issues. More work will be done in this area over the next several months.
Upstate has made significant progress in conducting due diligence on Community General. “Due diligence” is the process of investigation and discovery that two parties undertake before they enter a transaction, such as a merger, acquisition, or joint venture. Over the summer months Community and Upstate shared various documents with each other, allowing attorneys, accountants, and other experts to understand and evaluate business practice, finances, legal contracts, property conditions, etc. Dr. McCabe estimated that Upstate has reviewed more than one quarter million pages of Community's documents and has not found obstacles to the planned combination.
Research and analysis continue in the areas of clinical services and workforce. There are various models for consideration, and Upstate is actively examining them. Dr. McCabe and I met with representatives of 1199SEIU earlier this month to hear their interests and concerns, and Dr. McCabe said that he has had a similar meeting recently with the representatives of the unions active at Upstate.
Dr. McCabe said the timeframe for combining the hospitals is next year, possibly by mid-year. This is, of course, subject to the extensive review and approval process involving various government regulatory departments. This would include Certificate of Need (CON) approval by the state Department of Health. When the project is approved in 2011, the process of combining hospitals would begin. This process would likely take place over a period of years.
There were a number of questions from employees. These ranged from “What will happen to my position if the two hospitals come together?” to “Would you continue to be interested in a consolidation if the federal government slows down or stops health care reform?”
In the first case, it is too early to say how positions might be organized. This relates to the study of clinical services and workforce needs that remains to be completed. In general, the combination is likely to make the Community campus more busy, not less busy -- and that would be good for jobs.
To the second question, the answer is “Yes, even without federal health reform, the hospitals’ combination makes sense.” The economic forces facing hospitals and doctors are well underway and are likely to continue, despite what the next Congress may or may not do in the next year or two.
Dr. McCabe and I heard many encouraging comments about preparing for the future challenges and opportunities. I appreciate the good attendance and the constructive comments from employees.
The Community family made Dr. McCabe feel welcome, and he was pleased to hear good comments about the Upstate-affiliated physicians who have joined Community's medical staff this year.
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