Perspectives from:

A private practice physician

A former Rockville Hospital Board Chairman

...From a former Rockville Hospital Board Chairman

In 1986, having recently retired from 34 years of employment at Hamilton Standard, I became a volunteer at Rockville General Hospital on the Quality Control Committee. I went on to become Rockville Hospital Board Chairman in 1990. I am currently an ECHN Corporator.

Throughout my tenure as Chairman, I saw the need to work with Bill Johnson, who was Board Chairman of Manchester Memorial Hospital, to reduce costs by combining shared services such as laundry, food service and lab testing. This was the beginning of a partnership that ultimately resulted in the merger of the Manchester Memorial and Rockville General Hospitals in 1995 as Eastern Connecticut Health Network (ECHN). In addition to reducing costs, the merger improved services and created a broader spectrum of care to the communities served east of the river.

Shortly after the merger, low margins, a struggle to command market share and increased growth in long-term debt and pension liabilities challenged the financial health of the ECHN organization.  Solutions to these problems were included in the goals and objectives for the newly-appointed President & CEO, Peter Karl, in 2005. They included growing the outpatient services accessible for me, and my community around me, and so ECHN added access centers with new physicians and outpatient services in the major towns it serves.  Their plans predicted the necessary focus for providing outpatient care services while maintaining quality inpatient care at the two hospitals and building the relationships between its physicians and providers of hospital care, outpatient healthcare services, skilled nursing care and home care. As a result, financial progress was made each year, physicians began working more closely with hospital administration and the medical community and access to care was expanded throughout the comprehensive health system.

Now, fast forward to 2013. There are numerous financial constraints upon ECHN again. Current issues relating to Federal sequestration which decreased Medicare reimbursement; the introduction of a hospital user tax in order to balance the state budget; and upcoming challenges resulting from the implementation of the Affordable Care Act (ACA). One component of the ACA is to encourage doctors to keep patients well and out of the hospital setting, when possible, and provide care in an outpatient or home setting. This has resulted in a decline of inpatient beds occupied at both hospitals, but is precisely the direction of the healthcare reform. So, in order for our two local community hospitals to remain strong, we are left asking an important question. What do we need and want for ECHN? We need ECHN to be able to compete in the market and to do so ECHN must invest in capital equipment, facility upgrades and information technology and attract the patients who are receiving care at other hospitals. This has all led to the conclusion that ECHN would benefit from partnering to become part of a larger care provider network, just as we saw benefit from combining Rockville and Manchester Hospitals, so many years ago.

An ECHN Board of Trustees’ sub-committee was formed to recommend solutions to maintain a thriving future for our ECHN healthcare services. After years of investigation and review, the results and recommendation of the committee resulted in ECHN signing a letter of intent to negotiate the sale of ECHN to a partnership of the Tenet Healthcare Corporation and Yale New Haven Health System.

We had to make changes once before in order to keep our local hospitals and services open for our patients and we have collectively benefitted from those results. Standing still was not an option then…and it is not an option now. I hope this community will reflect on how far we have come over the years and how the changes have resulted in beneficial outcomes. And although change can be difficult, these changes will ensure that our communities will continue to be well served in the future.

Rudolph Luginbuhl

...From a private practice physician

I am a physician who retired from medical practice at ECHN last year. I remain a Corporator of ECHN and therefore will be asked to cast my vote on the merger between ECHN and Tenet/Yale.

Having participated in the process that led to ECHN's formation in 1995, I am most aware of the contracting and competitive reasons for consolidation in the health care industry.

Of late, the necessity for this business strategy has become more intensified by federal and state regulations and reimbursement pressures that demand even further reorganization.

New business alliances are now required to remain vital and competitive. By not meeting this challenge, a health care institution such as ECHN will stagnate for lack of adequate operating revenues and capital investment. In this highly competitive and demanding industry, dependent on exceptional service, quality care and the latest technologies, stagnation leads to obsolescence.

At the time of our deliberations regarding consolidation of Manchester Memorial and Rockville General hospitals into ECHN, many were concerned this process would lead to the loss of medical services and jobs in our community. Although changes in service location and staffing in some specialties occurred, the ultimate strengthening of our health network and preservation of services and jobs prevailed.

Now, the same concerns understandable arise. Change always brings anxiety and fear of the unknown. However, the inability to change brings the greater certainty of a downward spiral of events which will inevitably bring with it both a loss of local services and employment.

Although a merger with a for-profit entity was explored in 1995, it was felt that the intermediate step to create ECHN would suffice for a period of time. And it did. However, market forces fueled by reduced Medicare and state reimbursements require re-examination and more robust strategy. A variety of options have been explored, including additional local alliances, for-profit mergers and hybrids such as the proposed Tenet/Yale option.

I am quite pleased with the Tenet/Yale opportunity because it combines two crucial ingredients I value as a physician and a consumer. The first is access to capital resources that are necessary to maintain a first-rate hospital network in our community. The second is a link to Yale, a quality health care network with national recognition, which will help monitor and protect the quality and value of ECHN.

I have reviewed the due diligence done by ECHN's board of directors. I am comfortable they have addressed issues I want covered and those brought out in news articles and editorials. Many of these issues will be resolved through further negotiations and state oversight.

Tenet is uniquely positioned through its resources, experience, vision and current compliance policies to be a trustworthy, for-profit partner for ECHN. Yale will be an excellent medical partner to expand our clinical excellence. This merger should be a win-win solution for our ECHN community.

Robert Rodner, M.D.
South Windsor

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