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Partnership Advisory Group Discusses the Gaps Between Where We Are & Where We Want to Be

In the months since New Hanover County and New Hanover Regional Medical Center leaders announced an intention of exploring options for the health system, some have been asked why there’s a need to change anything about an organization that appears to be doing quite well. After all, NHRMC offers compassionate, high quality care at relatively low cost. It is involved in the community and is financially stable.

The reason to consider new ways of doing things became clearer at the February 6 meeting of the NHRMC Partnership Advisory Group.

NHRMC President and CEO John Gizdic shared the latest ranking of health indicators for our state and its counties. North Carolina ranked 36th in the country. Among NC’s 100 counties, those in NHRMC’s seven-county service area averaged 55th.

“We’re in the bottom half of the state, in the bottom half of the country,” said Gizdic. “When we talk about strategic needs, we are talking about NHRMC, but it is so much more than that. We’re talking about our ability to improve the health of our region.  That’s something we should all want.”

With more than 50 percent of its patients coming from outside New Hanover County, NHRMC has a responsibility to improve care and wellness in areas that have some of the worst health outcomes in the state. Even in New Hanover County, which ranked 19th, there are significant disparities to overcome.

The imperative to improve overall health can be seen in the rankings, as well as within the walls of NHRMC, where capacity is regularly above 90 percent and patients can wait hours in the emergency department to be taken to an available inpatient room.

As the health industry shifts to value-based reimbursements in which health providers are paid a flat fee for each individual, regardless of the intensity and frequency of the care they require, the pressure to find solutions to the biggest health challenges mounts.

But NHRMC’s ability to offer services in the region and introduce more cost-effective and innovative options for care is hindered by both its governance structure and limited access to personnel, capital, and technical resources.

The Advisory Group reviewed options for restructuring NHRMC that would give it more flexibility while remaining independent. They discussed establishing a parent company and transitioning to a hospital authority or a private, not-for-profit system. Each model offers different benefits, but not the access to the scale or capital that would help accelerate NHRMC’s work to improve the health of the region.

At that point in the discussion, Dr. Michael Papagikos asked, “Are we exploring options to remain independent, or are we proving that we can’t remain independent?”

The group then focused their attention on how independence is defined. Independence does not mean “standalone.”  NHRMC could remain independent, with local ownership and authority, and still enter partnerships that would add resources in key areas. Examples include NHRMC’s partnership with Atrium to manage its physician practices, NHRMC’s partnership with FirstHealth to offer Medicare Advantage plan, and NHRMC’s partnership with UNC School of Medicine to provide medical training in Wilmington.

Through the responses to the request for proposals (RFP), NHRMC could receive more of these types of options that could complement and expand what NHRMC is able to do with a change in structure.

Detailed descriptions of strategic needs and goals and the challenges NHRMC faces in meeting them are outlined in slides 19-40 of the presentation.

Request for Proposals Update
Responses from organizations interested in working with NHRMC are due back on March 16 and will be made public on March 30. The two weeks in between will be used to clarify information and legally review any request from the respondents to keep parts of their proposals confidential. The goal is to make as much of the proposals public as possible while honoring required legally required protections for strategic information.

At the time of the meeting on February 6, nine organizations had indicated their interest in responding to the RFP by completing non-disclosure agreements to gain access to additional information from NHRMC. Those nine include Atrium Health, Bon Secours Mercy Health, Duke Health, HCA Healthcare, LifePoint Health, Novant Health, Optum, UNC Healthcare, and Trinity Health.

NHRMC and New Hanover County are legally obligated to accept proposals from any organization that requests and completes an RFP.

The next meeting of the Partnership Advisory Group is February 20 at 5:30 p.m. in the New Hanover County Government Center. The meeting is open to the public. Recordings, minutes and presentations of each meeting are available online at www.nhrmcfuture.org.  Members of the public can also email the advisory group at PAGcomments@nhcgov.com.