Advanced Healthcare, Aurora & the Future...

I am the patient of an Advanced Healthcare doctor. My first reaction to the early news that Advanced Healthcare and Aurora were negotiating a joint relationship was one of wait and see.

Now, some weeks later, there is the outward indication of a significant change in relationship…a formal announcement by the two parties has been issued.

My initial reaction to the announcement over the week-end that this likelihood seemed nearly a fait accompli was one of concern. I was concerned for me as a patient, for my doctor as a participant, for Community Memorial Hospital as a threatened institution and for the whole healthcare topography in S.E. Wisconsin.

I had an unexpected opportunity over the week-end to experience healthcare first-hand. As the result, I also had the opportunity to talk with a couple of physicians…one a member of Advanced Healthcare and the other a member of another group [but who would be impacted by any issues ultimately surrounding the viability of Community Memorial]. I also had the opportunity to interact with employees of Community Memorial Hospital, although I chose to not engage any of them in this discussion.

The Advanced Healthcare doctor told me that he had mixed emotions as did many of his peers. He also stated an interesting statistic as follows: a handful of years ago, Advanced Healthcare was one of a couple of hundred similarly-sized group practices in the U.S. but today it is the sole group practice of its size left in the U.S. Each of the others has been acquired, has merged or has somehow been absorbed by another entity. He reminded me that even though each physician sees his patients as a sacred trust, the corporate folks understand that healthcare is a business. And businesses must remain competitive in order to survive. If one group of physicians lost its edge, many of its patients would quickly migrate to another practice that had the edge. We patients expect our physicians to be “loyal” to us, but we can move without those same feelings flowing in the other direction.

The non-Advanced Healthcare doctor told me that there were mixed emotions of a very strong nature inside and outside the systems involved. He said little else, I presume because of the highly-charged situation of which he is a part.

I saw no sign that staff members had changed in any way as the result of this news. Some probably had no idea that such news had been issued while others felt they would be okay no matter what. It is, after all, difficult to imagine that a hospital of the size and reputation of Community Memorial with its partnering relationship with Froedert could not survive very ably in almost any situation.

Maybe the other suitor earlier reported will step up to the plate with an offer to Advanced Healthcare that transcends the deal in the current discussion. If so, it could be that my concerns would be for naught; or it could be that I’ll have a whole new set of concerns.

If we simply take a look around us, we’ll see that there has been consolidation of insurers and consolidation of hospital groups. If the physician groups do not scale up in size, they will have lost much of their negotiating leverage with both the insurers and the hospitals. We cannot foretell what such consolidation will mean to the cost of healthcare; it is easy, however, to postulate increased costs given fewer alternatives and more buildings and more expensive equipment and less competition [in the form of fewer competing entities].

Physicians generate the bulk of patient flow for hospitals by their admitting profiles. So these physicians have significant leverage at the moment.

Could our local hospital emerge strong as ever? Certainly it could.

Could it emerge as a weaker entity? Certainly it could.

Could it simply go away as we know it today? If Aurora were to acquire or merge with Advanced Healthcare and then build a northern tier hospital as has been discussed; and, if Medical Associates were to conclude negotiations with ProHealth located in Waukesha and began referring patients in that direction…certainly it could.

Whatever your thoughts, this is an exciting and/or troubling time for we consumers of healthcare in this area.