We know our community may have questions about our healthcare future.

We are just beginning to explore the idea of a potential partnership, and while there is a lot we do not know today, below is a list of frequently asked questions to help you learn more about our vision for healthcare in our region.

You can also submit a question of your own in the box to the right.

Is NHRMC struggling financially?

No. NHRMC is clinically, financially and operationally strong today. Our strength puts us in a great position to go through this evaluative process and make the best decision about our future. We have great people who are working together to improve care and the health and well-being of our entire community. We recognize that, to build on this momentum, we need additional resources that will help us make investments in the people, services and technology that can make a difference.

How can I provide input and learn more?

NHRMC and New Hanover County will be open and transparent throughout this process and share updates as they become available. We encourage you to visit the Stay Informed page of this website to see upcoming community forums where you can provide input and sign up to receive email updates. We want to hear from you and learn what your vision is for health and wellness in the community.

Why are we moving forward with this process?

In recent years, NHRMC has expanded its scope to embrace a mission of leading our community to outstanding health. The health system, through its strategic plan, is working toward a vision of the region serving as a model for health and wellness, with all residents having convenient access to affordable care that’s equitable and customized to their unique needs and preferences.

In pursuit of its mission and vision, NHRMC is committed to empowering employees and providers to innovate, not only to meet the needs of the growing population through advanced inpatient care, but also for ways to keep patients out of the hospital through programs that help them better manage their health. This approach recognizes that some of the biggest threats to wellness include lack of education, drug abuse, poverty and violence, and that partnerships with others working to eliminate these barriers are often the best path to success.

As NHRMC looks to the future, it’s clear more resources are needed to invest in the people, technology and services that can make better health and wellness a reality. But inevitable changes and disruption in the healthcare industry will require NHRMC and the county to consider new ways to support the investments that can make a difference.

We have an ambitious mission and vision for the future and are open to opportunities to rapidly move our mission forward. By considering whether a different ownership structure with a like-minded partner would better serve this community, the New Hanover County Commission is taking a reasonable and proactive step to evaluate the best way to secure the future of healthcare in our region.

What are we hoping to achieve by exploring a new ownership structure?

County and NHRMC leaders are committed to discussing the best way to serve the needs of the community. One possible path forward is for NHRMC to become part of a larger healthcare system that could accelerate work to ensure the members of our community are able to get the care and support they deserve in ways that are more convenient, affordable and customized to their needs.

Who will evaluate the options?

A Partnership Advisory Group, made up of 21 people from throughout the community, will be working to understand the changing healthcare industry and the challenges and opportunities NHRMC faces within it.

The Partnership Advisory Group will help develop priorities for the Request for Proposal (RFP), select a minimum of five health systems that will receive the RFP, evaluate the proposals received and examine the options for maintaining county ownership. The advisory group will then provide a recommendation on next steps to the Board of Commissioners and NHRMC Board of Trustees. A recommendation could include negotiating with one or more systems regarding proposals or pursuing other ways to support NHRMC as a county-owned hospital.

Who will make the decision?

The Partnership Advisory Group will make a recommendation on the best course of action after a thorough evaluation of the proposals received and NHRMC’s ability to succeed as an independent organization. That recommendation will go to the NHRMC Board of Trustees for approval as well as the New Hanover County Board of Commissioners. Any agreement signed would be a three-way agreement, between the other organization, New Hanover County, and NHRMC, as represented by the CEO with approval from the NHRMC Board of Trustees.

What are the priorities moving forward?

In evaluating the right ownership structure, we’ll consider who is best able to advance the following priorities:

  • Improving access to care and wellness through more consumer-centric options.
  • Advancing the value of the care we provide through higher quality and lower costs, effectively managing the health of our region to not only treat the sick but keep them well.
  • Achieving health equity through community partnerships and activities that remove barriers to care, enabling our residents to achieve their own optimal health.
  • Supporting our staff and the culture that has made NHRMC one of the top places to work in the county.
  • Partnering with providers to make southeastern North Carolina an excellent place to practice medicine so we can continue to attract talented and compassionate providers to care for our growing population.
  • Driving quality care throughout the continuum and helping facilitate transitions with other providers to deliver more seamless and coordinated care models.
  • Growing the level and scope of care already in place for all, regardless of ability to pay.
  • Investing to ensure the long-term financial security and future of our health system.

How will this impact services?

NHRMC’s priority will continue to be providing exceptional care to our patients and the community we serve. It’s our goal to improve access to care, services and wellness through the availability of more options. A partnership search process will not affect our daily operations, and nothing changes today for our patients, employees, providers or community. Our focus on patient care, quality and safety does not change during this process.

Where would the money go if NHRMC is sold?

The proceeds would go directly to New Hanover County Government, as the owner of the health system. The county would then be in a position to strategically invest the money back into the community. Examples could include:

  • Education to provide more funding for public schools to benefit all of our children, as well as continuing education that can help build the county’s workforce and attract new business and jobs.
  • Health and wellbeing for our citizens, to create better health equity across the community. This could come in the form of more community health programs, resource assistance and meeting people where they are to improve health outcomes.
  • Community priorities like more affordable and workforce housing options and expanding treatment options to help combat the opioid epidemic.
  • Economic development that focuses on small business growth and development by supporting entrepreneurship.
  • Public safety to provide more resources to keep our community safe and secure.
  • Community infrastructure to meet the needs of our growing community, focusing on debt relief for the county and stable taxes for our citizens.

How does this impact employee pension and retirement plans?

NHRMC employees and retirees can be assured their vested retirement and pension funds are safe and secure. A change in ownership would not affect those funds. If the decision is made to move forward with negotiating an agreement with a new partner, we would prioritize ensuring NHRMC employees’ years of service are valued for vesting purposes as part of any new retirement benefit provided.

Can we have more time for discussion before a decision on selling is made?

Yes. New Hanover County Commissioners can build time into the evaluation period well beyond what is required by state statutes to ensure the public has the opportunity to be informed and engaged in discussions around the future of NHRMC.

The vote on September 16 was just the first step in the exploration process. It does not represent a decision to change ownership. With that vote approved, the county can move forward with a slow, deliberate and transparent plan for the development of a Request for Proposals, the evaluation of the proposals received and an ultimate decision on whether to proceed with any of them. At each step, the documents will be publicly available, and there will be public hearings and community forums for additional input. This process could take several months or more.

Can the public vote?

The North Carolina state statute that guides the sale of a public hospital states that the decision is solely in the hands of the County Commissioners, with review by the State Attorney General. A voter referendum must be authorized by the state constitution or by statute, and in this case it is not. The statute does outline a very public process that includes making all proposals public and conducting public hearings.

Studies show mergers can lead to higher prices. If Commissioners approve a merger, why shouldn’t we expect that to be the case here?

The studies typically cited are looking backward at a time in which payment for healthcare services was based exclusively on fee-for-service models.

Few forward-looking healthcare systems see raising prices as an effective long-term strategy. Insurers – private or public – aren’t going to pay higher prices. And increasing requirements for price transparency will mean consumers can choose based on price.  The best path forward will be to offer lower-cost options for care and more effectively manage the health of the population we serve so their overall cost of care is lower.

Would we consider options other than selling?

Yes. All options are open for evaluation, including not changing anything about the current structure. Since the Commissioners voted to move forward, we expect to receive proposals for different types of partnerships that can be weighed against each other and evaluated based on the benefits and risks are inherent with each model. If the proposals received do not fit the established priorities by the county, hospital and Partnership Advisory Group, there is no requirement to move forward and the work of the Partnership Advisory Group would then focus on remaining independent.

How would a larger system recoup its investment in buying NHRMC if changes in the healthcare industry make it hard for NHRMC to remain profitable?

The primary draw for a system to consider purchasing NHRMC would be the opportunity to build on a strong system and grow and expand the services here. Our population is booming, and the need for services is increasing. A larger system has the access to capital to invest in the facilities, technology and people to support all the projected growth. They would also be able to share infrastructure in data systems and analysts that could help NHRMC pivot to new business models to more effectively share the risk inherent in population health management and improve overall access to advanced services such as heart, cancer and neuroscience care as well as better health maintenance.

Is selling the hospital a “done deal”?

Absolutely not. The Commissioners voted to move forward with soliciting proposals on September 16, and we can expect to learn a lot about who is interested in partnering with NHRMC and what types of options they envision. Those proposals will be publicly available on this website, and there will be diligent research and evaluation done by the Partnership Advisory Group and the Commissioners, with input from the community. Commissioners can decide to move forward with one proposal or decide to retain county ownership. Input from NHRMC leaders, physicians, employees and community members will continue to be an important part of the process before any decision is made, which would be many months from now.

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