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UConn Health Center Proposal Draws Fire From Two Hospitals

ARIELLE LEVIN BECKER

March 16, 2009

In their pitch for a merger of the UConn Health Center and Hartford Hospital, University of Connecticut officials have boasted that their plan could represent a détente in the area's long-running hospital wars.

But two other hospitals see it as an offensive.

Leaders of St. Francis Hospital and Medical Center in Hartford and Bristol Hospital say the proposal, which includes the state-funded construction of a $475 million hospital, amounts to state taxpayers' giving two of their competitors a new hospital and a major edge at a time when other hospitals are struggling to balance the books.

"I think that's horrendous public policy," St. Francis President and CEO Christopher Dadlez said. "It gives an undue advantage to a sizable organization."

Dadlez and Bristol Hospital President and CEO Kurt Barwis say a new hospital in Farmington could lure away patients with private insurance, an alarming prospect as hospitals throughout the state struggle with tight margins and see more patients who are uninsured or covered by Medicaid, which pays significantly less than private carriers.

That kind of change in the health care landscape could strengthen some hospitals while weakening others.

"It would potentially jeopardize the mission of our hospital," Barwis said.

The opposition from St. Francis and Bristol hospitals adds another wrinkle to the choice facing lawmakers, who are already grappling with a massive budget deficit and must now decide whether to commit to spending a projected $605 million over 10 years on the proposal.

UConn officials say their plan is needed to save the financially struggling Health Center and point out that the state would own the new hospital, while Hartford Hospital would contribute more than $100 million to the Health Center and assume responsibility for any future deficits it runs. Second-Class Partners

The skirmishes emerging over the proposal echo years of intense competition among the region's hospitals.

When UConn officials in 2007 proposed building a 352-bed hospital to replace John Dempsey Hospital, other area hospitals, including Hartford, joined forces to defeat the plan.

This time, Hartford Hospital and the Hospital of Central Connecticut are part of the UConn- Hartford proposal, which calls for a 250-bed hospital. And all area hospitals, including St. Francis and Bristol, are included in another part of the plan, a collaborative aimed at improving teaching, research and public health.

Officials at St. Francis and Bristol have embraced the collaborative, but say that it can be done without the new hospital. Dadlez said that a better plan would be to expand the collaborative to include clinical services, involving all of the area hospitals.

"We want to be a full partner," Dadlez said. "We don't want to be a secondary player."

But UConn President Michael Hogan said the proposal reflects the results of a 15-month process of discussions with other hospitals, during which only Hartford offered a comprehensive proposal.

"[St. Francis] simply did not come out with any plan, any configuration of a plan that would look to meeting our clinical needs," he said.

Dadlez and Barwis said that when UConn solicited proposals for a partnership, the idea that the state would kick in so much money was not part of the equation.

"If I would have thought for one minute that there was a chance to get a free hospital out of this deal, I would've proposed with a full proposal," Barwis said. "I think anybody in the state would've done it."

Patient Drain

The proposed merger comes at a time when hospitals statewide face a dire financial picture.

Because programs like Medicaid and Medicare pay hospitals less than it costs to treat a patient, hospitals have historically relied on private patients and investment income to make up the gap.

But the economy has battered investment income, and a new hospital in the wealthy Farmington Valley could lure away the privately insured patients that other hospitals rely on.

"If patients that are paying patients are siphoned off from St. Francis and wind up going to a new academic medical center instead of seeking services here, we're left holding the bag," Dadlez said, noting that St. Francis already sees a large portion of "safety net" patients.

But Hartford Hospital spokeswoman Lee Monroe described the plan as a way to benefit all area hospitals by making sure that UConn has a viable teaching hospital that would attract more medical residents to the area and produce more physicians.

"We think the plan that was proposed will strengthen all hospitals and raise all boats," she said. "The plan will keep the citizens of Connecticut within the state for medical care rather than migrating to New York or Boston."

More Than Money

Officials at St. Francis and Bristol also see an unfair advantage in the details of the plan for moving forward with the new hospital.

The proposal amends the permitting process required for the new hospital, calling for the Office of Health Care Access, which would have to rule that a new hospital was needed, to conduct an "expedited review," waive part of the process and prohibit third parties from participating in the proceedings.

Hogan and UConn Chief Financial Officer Richard Gray said that the request was aimed at getting started on the new hospital as soon as possible.

But state Sen. Mary Ann Handley, co-chairwoman of the higher education committee, called the request a serious concern. "It really just walks around OHCA and says OHCA doesn't matter," she said.

In a statement, St. Francis officials said the proposed exemptions would "severely impair" other parties from weighing in. "No other hospital in this state would be granted these exemptions," the statement said.

Despite the objections, Hogan said that the plan represents progress.

"We now have virtually all but one of the major hospitals in the Greater Hartford area supporting the partnership," Hogan said, referring to St. Francis. "That's, as anyone will tell you, a remarkable accomplishment, the first that's ever happened."

"So the issue is whether the fact that one is on the outside and can't think of a way in is reason enough to ignore this significant opportunity," he said.