One began in the last century with the desire to have a hospital in Baltimore that would treat black patients and would train and hire black medical staff. The other began in the last century with a small order of French nuns invited to Baltimore by the archbishop to treat people in their homes.
Despite their disparate histories, Liberty Medical Center and Bon Secours Hospital have been brought together by some thoroughly modern, and some 21st century, considerations.
The two urban hospitals are seeking to secure their place in a changing medical marketplace, combining to make themselves into the kind of full-service, cost-efficient institutions that appeal to managed care insurers. Liberty's merger into the Bon Secours Baltimore Health System is expected to close in a few weeks.
Their efforts are given a sense of urgency as the government programs that insure most of their patients are shifting rapidly into HMOs and similar managed care plans.
Medicare and Medicaid have lagged behind commercial plans in shifting from patient-choice, fee-for-service insurance to managed care, in which the health plan exercises more control over what care patients receive and where they receive it. But both are catching up rapidly -- Maryland plans to move all its Medicaid recipients into managed care plans within six months next year -- and Bon Secours and Liberty must move nimbly to adjust.
They've adjusted in the past; each has reinvented itself several times.
Liberty is a successor to Provident, the city's traditionally black hospital that began in a rowhouse in 1894. In financial trouble, Provident was essentially taken over in 1986 by Lutheran Hospital in a merger that formed Liberty. Since Provident had a relatively new building (its facility on Liberty Heights Avenue opened in 1970) and Lutheran an old one, the operations were consolidated on the Provident campus.
The sisters of Bon Secours (French for "good help") were invited to Baltimore in 1881 by Cardinal James Gibbons. The sisters opened a hospital in West Baltimore -- the original building, on Fayette Street, is still in use -- in 1919.
The order opened hospitals in other cities, and created an overall management structure, Bon Secours Health System, in 1983, based at the provincial house and retreat center for the Congregation of Bon Secours order in Marriottsville.
Just six hospitals as recently as 1993, the Bon Secours system is now, in effect, a billion-dollar health corporation.
