Mega Hospital Merger

[Ben]

Apparently, as announced today, Oakwood HealthCare, Beaumont, and Botsford Hospital will merge into a new, yet to be named, organization. This really doesn't mean that much [[remember Henry Ford and Beaumont) but I think that a system like this could hurt hospitals within the City of Detroit. Hospitals like Henry Ford already provide a great deal of charity or discounted care and when a system with 30% market share that only has facilities in the suburbs comes into existence I could see it cannibalizing the market and forcing Henry Ford and Tenet-DMC to close hospitals in the city. My sister worked for Sinai Hospital of Detroit and the same thing happened there. Wealthy suburban residents were pulled to suburban hospitals, causing closures. It's kind of embarrassing in a large [[geographically) city of 700,000 we only have 5 hospitals.

[Gistok]

Well it's not yet as bad as you think.... when St. John bought out all the smaller hospitals on the east side... they did close them... siphoning all of their patients to the St. John Medical Center on Moross. When they bought Macomb and St. Clair county hospitals they moved all major care to the Moross campus as well. The city HQed hospitals all bought up suburban and outstate hospitals to try to minimize the scenario you mentioned Ben, and bring their more care intensive patients to their Detroit locations.

But on the flipside, hospitals that have NO city locations, tend to keep it that way.

[SWMAP]

Don't be embarrassed! Detroit region ranks in the TOP 7 urban areas in the country for medicine, research, etc. Only 6 other cities have equal or more access to care in academic centers. We are very, very lucky here. If you are going to be sick, get sick here.
As to the three merging hospitals, they are all essentially community hospitals and will do well together. Henry Ford & Beaumont was going to be a merger of an academic medical center and a community hospital - not a marriage of equals at all. And, in case you wonder, It was HFHS that was the dominant partner, which is why the doctors at Beaumont put the kibosh on it.

[Ben]

That may be the case in the suburbs, but the inner city is undeserved in terms of health care. This article from the WSJ I think is really compelling, http://online.wsj.com/news/articles/...93747851830485
It's kind of hard to imagine, but from DMC/Henry Ford to Beaumont-Grosse Pointe there is no hospital or emergency department in the city.

[Hypestyles]

That may be the case in the suburbs, but the inner city is undeserved in terms of health care. This article from the WSJ I think is really compelling, http://online.wsj.com/news/articles/...93747851830485
It's kind of hard to imagine, but from DMC/Henry Ford to Beaumont-Grosse Pointe there is no hospital or emergency department in the city.

The new combined entity should take over the Herman Keifer site and its empty DPS properties nearby, and do a complete overhaul. Also, where is that abandoned Aurora hospital? Also, abandoned industrial sites could be cleaned up and converted into hospital campuses.

[Bham1982]

Don't be embarrassed! Detroit region ranks in the TOP 7 urban areas in the country for medicine, research, etc. Only 6 other cities have equal or more access to care in academic centers. We are very, very lucky here. If you are going to be sick, get sick here.
As to the three merging hospitals, they are all essentially community hospitals and will do well together. Henry Ford & Beaumont was going to be a merger of an academic medical center and a community hospital - not a marriage of equals at all. And, in case you wonder, It was HFHS that was the dominant partner, which is why the doctors at Beaumont put the kibosh on it.

Could you explain to us how Beaumont is a "community hospital" given that it

1. has a medical school,
2. is the largest and most profitable hospital in the region
3. has twice as many doctors as #2 Henry Ford and
4. scuttled the past merger because of a revolt among Beaumont doctors.

On what planet is the biggest, richest hospital, with the most doctors, the biggest market share, and a medical school, anything but a major research medical center?

No, it isn't Johns Hopkins, Columbia-New York, or Harvard Mass-General, but it isn't Alpena Regional Medical Center either. It's a major teaching hospital.

[MikeyinBrooklyn]

I agree with everyone's points here. This could end some rendundancy in regional coverage, but it also might mean there is less total care going on. I know that hospitals struggle everywhere [[in NYC, whose population grew substantially while I lived there, they shut down many hospitals, particularly emergency rooms). If the resulting institution would be more financially stable, I guess I am for it. The nature of patient service is changing in many ways. I think as a general trend fewer doctors will have private practice offices, and people will mostly visit small clinics and urgent care centers for most things, moving on to hospitals for major issues. We are lucky in Detroit with a plethora of high quality facilities. And it is a huge economic engine for the area.

For the new name, I like OBeBo.

[Ben]

I don't see the Herman Keifer site getting taken over but I would love if the former Mercy Hospital or Northwest Hospital or Southwest Hospital would reopen.

[313WX]

I don't see the Herman Keifer site getting taken over but I would love if the former Mercy Hospital or Northwest Hospital or Southwest Hospital would reopen.

The Samaritan Center occupies Mercy Hospital [[on Warren and Conner).

As far as any of the other hospitals opening, fat chance. The 3 hospitals that merged are suburban to the core.

[Ben]

I know, It's wishful thinking on my part. I just wish people in certain parts of the city had more healthcare options.

[Danny]

Whoop dee doo!!! for those private pay hospitals. Even the one where I was born. It's all about the profits. When hospitals become a corporate entity. Their profits of good as liquid.

[MikeyinBrooklyn]

Danny, there need to be profits, or most people who work in health care wouldn't be working in health care. Profitable hospitals pay their staff better than money losing hospitals; they also tend to have better medical technology and more pro-bono care. The reason that neighborhood hospitals in the city have gone by the wayside is that no one is around to foot the bill for people who can't pay for their own care. I would favor taking Medicaid money that flows through individuals and redirect a good chunk of it to operate neighborhood clinics that offer basic services in Detroit's neighborhoods. It would be better spent that way, IMO.

[Ben]

Mikey, the issue is that all of the hospitals in SE MI, except for Tenet-DMC, are not-for-profit. This means that their main objective is to care for the community. In fact, they are exempt from property taxes so they can use that money for charity care.

[SWMAP]

As to the cancelled Beaumont/ HFHS merger, the prevailing opinion, often reported, was that HFHS was the stronger partner in every way. Beaumont doctors scuttled the merger because they feared Beaumont would be subsumed in the merger, losing it's identity and that the doctors would have to give up their lucrative private practices to become employees [[as HFHS physicians are, and as the doctors at the Mayo Clinic are and, likewise at the Cleveland Clinic and Johns Hopkins - all the prestigious research centers). You can look it all up for confirmation.
Not to diss Beaumont - it is a fine community hospital! I do not say the same about Oakwood. Sad to partner with them. Garden City is a nice little osteopathic hospital. Certainly you would agree that these are not prestigious research institutions.

I stand by the assertion that Detroit is well-served with world-class's medical clinics and research. The National Institute of Health operates it's largest satellite from here in Hutzel Hospital. I believe that installation has a research budget of more than $100 million annually.
And, close by, U of M hospital is another one of the top ten hospitals in the nation for clinics and research.

[Ben]

As to the cancelled Beaumont/ HFHS merger, the prevailing opinion, often reported, was that HFHS was the stronger partner in every way. Beaumont doctors scuttled the merger because they feared Beaumont would be subsumed in the merger, losing it's identity and that the doctors would have to give up their lucrative private practices to become employees [[as HFHS physicians are, and as the doctors at the Mayo Clinic are and, likewise at the Cleveland Clinic and Johns Hopkins - all the prestigious research centers). You can look it all up for confirmation.
Not to diss Beaumont - it is a fine community hospital! I do not say the same about Oakwood. Sad to partner with them. Garden City is a nice little osteopathic hospital. Certainly you would agree that these are not prestigious research institutions.

I stand by the assertion that Detroit is well-served with world-class's medical clinics and research. The National Institute of Health operates it's largest satellite from here in Hutzel Hospital. I believe that installation has a research budget of more than $100 million annually.
And, close by, U of M hospital is another one of the top ten hospitals in the nation for clinics and research.

Frankly, I do disagree, and I believe the people at Beaumont would as well. A hospital with a Level One Trauma Center is not a community hospital, it's an academic medical center. Metro Detroit may be well served by its health care facilities but the City of Detroit has a broken health system that is sorely lacking. The issue isn't academic medical centers, it's community hospitals and health centers for the City of Detroit. A city or region can have all the facilities in the world but without community access can still have a broken system of health care.

[SWMAP]

You should look it all up. Detroit has plenty of beds and access to some of the finest medical care in the country. Only seven geographical areas have the medical infrastructure we can boast of.
I don't doubt that Beaumont is a research facility, but it does not rank with the academic centers. And you should be able to see clearly that Beaumont aligning with Oakwood and Botsford, rather than HFHS shows the level of prestige that Beaumont is aiming for. Rather than academic ranking, Beaumont is going for survival.
I think many people forget that Detroit's medical stature came about through the autoworkers. When most people in other places did not have employer-provided medical insurane, Detroit had annually expanding insurance. A lot of money was available here and clinics, labs, research followed. That heritage continues. WSU medical school is still the nation's largest.

[hybridy]

Beaumont is a teaching hospital not an academic medical center or community hospital.

These mergers and partnerships are commonplace responding to the affordable care act. Metro Detroit has a large percentage of Medicare and Medicad patients who's reimbursables are being reined in due to readmissions and hospital acquired infections. The number of patient beds is also high for the region, though they're not of contemporary standards commonplace in the suburbs with a "good payer" patient load. Mergers and acquisitions will continue and our healthcare system will be begin to look closer to India's hub and spoke model. Smaller general/ community hospitals that feed into large regional centers with all the specialists. Hospital stays are shorter and census is trending down over time, but folks admitted are sicker with multiple issues. Systems are taking their government reimbursables and focusing on the home health model. Preventative care and healthy living in the community at large. Reducing patient stays, but acing speciality interventions [[joint replacement, cardiac catheter procedures) The largest issue is the folks living with multiple chronic diseases [[diabetes, cardiac issues, addiction). Healthcare tourism is on the rise and large corporations will continue to parter with systems of excellence for discount procedures similar to Walmart and mayo clinic. This is the realty of it and I'm designing it for clients throughout the world.