Scramble for a health-care partner Presumed suitors eye hospital's educated, insured patients

March 05, 1998|By Dana Hedgpeth | Dana Hedgpeth,SUN STAFF

All four of the possible suitors scrambling to claim the 233-bed Howard County General Hospital want it for the same reasons -- its educated, affluent and insured consumers. But each probably has a different vision of what sort of hospital the county will have after a merger.

To two of the hospital's presumed suitors, the Johns Hopkins Health and Helix Health systems, getting Howard County General would be a further expansion in the region.

If the University of Maryland Medical System took over, it would be, as one health-care expert puts it, a bit like the "mother ship" coming in for a landing: The university system has already co-established an oncology center and a rehabilitation center at the hospital.

For St. Agnes HealthCare, it would mean absorbing a nearby competitor.

Each of the suitor's portfolios shows how mergers, consolidations and growth have become a daily diet in the health-care industry. Howard County General is one of the handful of hospitals in the state that has not been swallowed up, according to the Maryland Hospital Association.

Howard County General officials say they plan to pick a partner or decide to remain independent -- which many say is highly unlikely -- by the end of the month.

Those officials have taken steps to calm community fears -- announcing plans to set up a foundation to fund community health-care projects and requiring that two-thirds of any new board of directors come from Howard County.

But the details of the future of the hospital -- and health care in Howard County -- remain unknown.

Here is a snapshot of each of the presumed suitors -- hospital authorities have never identified the finalists -- and their possible effect on Howard County General:

The University of Maryland Medical System -- including University Hospital, the Maryland Shock Trauma Center, a rehabilitation center, the Greenebaum Cancer Center and a long-term care and nursing facility -- has about 4,000 full-time employees and an estimated $500 million in annual revenue. In addition, it has built specialty networks using local health-care entities across the state -- including Howard County General -- particularly in cardiology and neurology.

Staff reduction

This year, it cut about 200 employees after suffering a $3 million loss in profits for the first quarter of the fiscal year.

Getting Howard County General would be one of Maryland's first major takeovers of a community-based hospital. "Our interest would be to make Howard County General the strongest community hospital in the state," said Nelson Sabatini, UMMS vice president for integrated delivery systems operations.

Johns Hopkins Health System, widely regarded as one of the nation's leading teaching institutions, runs its landmark hospital in East Baltimore. Acquiring Howard County General would position Hopkins in a lucrative market.

"Hopkins has a very [underinsured] population area now," said Robert Murray, executive director of the state's Health Service Cost Review Commission. "Having a presence in Howard County with a more affluent, insured population equalizes their patient mix."

Even as it embarks on a $200 million project to build a cancer treatment center and nearby cancer research building on the East Baltimore medical campus, Hopkins is making a presence in Howard.

Unique services

This year, Hopkins will open a 5,000-square-foot project called Johns Hopkins at Cedar Lane. Using some of Hopkins' money, technology and staff, a group of local internists will establish a geriatrics clinics, preventive-care programs and a clinical research center.

"We're not trying to bring in primary care [doctors] or specialists who are already here, but bring in unique services that aren't here," said Dr. Gary Milles, a partner in Milles, Oken & Seals who will be involved with the clinic. "[With Hopkins'] size and capital, they can do things we can't."

But some health-care experts caution that in the long run a merger with Hopkins or UMMS could create unwanted competition between their doctors and Howard County doctors.

Some point to the Hopkins facility at Green Spring Station in Baltimore County -- a facility with a mix of Hopkins-affiliated doctors practicing full time in offices rented from Hopkins and faculty doctors from the Hopkins medical school who spend some time at the suburban facility.

"One of the complaints with a larger entity like Hopkins is that the smaller outfit of Howard County General will see its client base gobbled up by the larger company's doctors," said Dana Forgione, an associate accounting professor at the University of Baltimore who specializes in health-care management. "[Howard County doctors] could get rather upset because they say, 'I'm not supposed to have to fight off cannibalism. We merged; we're partners, not competitors.' "

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