Hospital health system growing Network of clinics, labs aimed at keeping patients in county

February 09, 1997|By Erin Texeira | Erin Texeira,Howard County General Hospital Pub Date: 2/09/97 SUN STAFF

In the past few years, Howard County General Hospital in Columbia's Hickory Ridge village has quietly gathered around it a collection of local clinics, test facilities and outpatient care centers to form a single health care entity called the Howard Health System (HHS).

As part of national trend toward health consolidation, the nonprofit corporation with 14 branches is seeking to take charge of health service and referrals for a growing number of Howard residents.

And the organization is still expanding. The most recent addition was a high-tech heart diagnosis center -- the county's first cardiac catheterization lab -- that opened in September, and this spring a cancer support center and children's unit are to open.

TC The aim: to keep patients -- and their money -- in the neighborhood.

"People in Howard County told us they didn't want to go to Baltimore or Washington to get health care," said Victor A. Broccolino, president of Howard County General, which created HHS. "This health system provides a broader range of services than the hospital sitting here alone could provide. The hospital in many cases does not have the wherewithal to provide all the things our patients need -- but we have the contacts to other facilities that can do it."

Although HHS now handles health care and treatment for thousands of county residents every year, most don't know that it exists, let alone what it does -- which experts said is not unusual.

"By and large, patients don't know about these types of systems," said John Colmers, director of the state Health Care Access and Cost Commission. "There has been such upheaval in the health care field that patients have been buffetted around. Things are still settling down in this new system."

Among the key health-care changes driving the creation and expansion of HHS and other growing health conglomerates are the rise of managed-care insurance plans and their tremendous pressures to drive down costs and make health care delivery more efficient. Hospitals have been left competing for market share.

"The reasoning is, the more services I can provide, the more revenue I can steal from other hospitals and beat them out," said Robert Murray, executive director of the Maryland Health Services Cost Review Commission.

The downside of these trends, experts say, is that the growing health care systems all tend to offer somewhat similar services -- giving rise to a market glut.

The Howard Health System stemmed from an effort in the mid-1980s by Howard County General officials to develop a so-called integrated health care delivery system to exist on one site -- much like a university campus -- in Columbia.

High land prices made the plan all but impossible, Broccolino said, but HHS was created in 1988 -- if only on paper -- instead.

In the beginning, the system was composed of Howard County General and Howard County Health Services Inc. (HSI), a sort of subsystem of health clinics. Among other things, HSI diagnoses sleep disorders and does respiratory care for nursing homes.

For several years, the system stayed small -- but in 1995 it began to expand: In the spring of that year, officials opened a radiation ,, therapy center and signed on with the Howard County Health Network, a group of private doctors that contracts out to hospitals.

That December, the system opened a radiation therapy center, and by the next summer it had started centers for outpatient surgery, outpatient testing and home health care.

"HHS was the vehicle through which we could accomplish those things," said Broccolino, who became president of HHS when he joined the hospital in 1990. "By no means are we providing the full spectrum of services -- we are a community hospital first and foremost.

"But we have a broader range of services than almost any other community hospital in the state."

The system is run by a team of hospital and HSI representatives that meet weekly, Broccolino said.

The only aspects of the original campus plan that have not yet been created are a health club, day-care center and nursing home, he said.

Howard County General, which opened in 1973 with 59 beds, now has 233 beds, 1,300 employees and an $80 million budget for the fiscal year ending in June. It recently has been eyed by potential purchasers, but Broccolino has said the hospital is not negotiating a sale.

Since it opened four months ago, the Central Maryland Heart Center has performed cardiac catheterizations on about 40 patients, said Dr. David Jackson, associate director of the center and a cardiologist in Columbia.

The lab -- in which doctors insert tiny tubes in patients' arteries to take pictures that will help them find heart abnormalities -- is now in a temporary building adjacent to the hospital. A permanent building is set to open within three months at the hospital, officials said.

"This is a service that patients simply couldn't get outside of major city centers even five, 10 years ago," Jackson said.

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