Dartmouth-Hitchock Medical Center and Mt. Ascutney Hospital and Health Center announced a joint agreement last week in which DHMC will become the employer of MAHHC's new chief executive officer and DHMC's co-president will become a voting member of MAHHC's Board of Trustees, according to a March 17 press release.
The hospitals' administrators believe that the new arrangement will help strengthen the hospitals' relationship and improve health care for patients in the Upper Valley, DHMC's vice president of regional development Deanna Howard and MAHHC's Director of Marketing and Development Carolyn Shapiro-Wall said in interviews with The Dartmouth.
"We think it creates a tighter relationship," Howard said. "Because so much of the care is provided by both our organizations, we think it's important for [MAHHC's] CEO to have visibility and presence at DHMC to enable better relationships."
DHMC administrators approached MAHHC about the arrangement after the announcement that MAHHC's current CEO, Richard Slusky, will retire at the end of September, Shapiro-Wall said. Slusky has worked for MAHHC for 28 years, according to the press release.
MAHHC, located in Windsor, Vt., is currently conducting a search for a new CEO, which is on schedule to be completed by the end of the summer, according to the press release
MAHHC will select its new CEO but "[DHMC] will obviously have a role" in the process, Howard said. MAHHC is on schedule to complete its search by the end of the summer, according to the press release.
DHMC will employ MAHHC's new CEO, but he or she will work full-time at MAHHC and be fully accountable to MAHHC's Board of Trustees, Howard said. The CEO will participate in DHMC's Senior Leadership Group and will have access to educational opportunities at DHMC, Howard said.
The involvement of MAHHC's CEO in DHMC's strategic planning process will better allow for the consideration of the entire community's needs, Shapiro-Wall said.
"The needs of the patients in our community will have a voice, a voice that they haven't had before," Shapiro-Wall said.
MAHHC will pay a "contractual fee" to DHMC for employing MAHHC's CEO, Howard said.
"The arrangement doesn't have a financial impact on either hospital," Shapiro-Wall said.
DHMC has had a similar arrangement with the CEO of New London Hospital, in New London, N.H., for several years, Howard said. Such arrangements create "stronger coordination of care and alignment of services," Howard said.
Collaboration between hospitals is increasingly common because health care is becoming more difficult to provide and "hospitals struggle every day just to try to break even," Shapiro-Wall said
"Our reimbursement is so poor that we need to be creative and innovative and make sure we're not duplicating services," Shapiro-Wall said. "This is the smart way to find ways to provide better-coordinated care."
Last week's agreement also provides that MAHHC's Board of Trustees will create a new voting position on the board for DHMC's co-president, Nancy Formella, Howard said.
"The purpose of a [DHMC] leader to have a membership on [MAHHC's] board is to hear the perspective of the community and broaden our understanding of their needs," Howard said. "It's certainly nothing about control."
The position will not be officially created until MAHHC's incorporators the group that must approve changes to the hospital's bylaws vote on the change during their annual fall meeting, according to Shapiro-Wall. Yet MAHHC's "assumption is that it won't be an issue," she said.
A stronger relationship between the hospitals will improve health care in the community because DHMC and MAHHC "share many patients," Howard said.
MAHHC, unlike DHMC, has an inpatient rehabilitation center to which DHMC patients are often discharged, Howard and Shapiro-Wall said. MAHHC patients are sometimes sent to DHMC for services that MAHHC does not have the resources to provide, Shapiro-Wall said.
"There's a big interdependency in those areas specifically," Shapiro-Wall said about MAHHC's rehabilitation unit and DHMC's range of services.
Shapiro-Wall emphasized that while both hospitals' administrators are "very optimistic" about the arrangement, the initial terms of the contract will only last for one year.
"It's not a forever' deal, so if for some reason it isn't working well, we don't need to renew it," Shapiro-Wall said. "But we hope and think that won't be the case."
Shapiro-Wall said MAHHC administrators are "very surprised" that they have not received much feedback from the community about the agreement.
"We hoped we would have heard more," Shapiro-Wall said. "Our hope is that people are truly understanding that we're not being taken over by [DHMC], as people may assume. Our hope is that people understand that this is a well thought-out decision in the interest of the community."
Nancy Loux, president of MAHHC's Board of Trustees, said that the arrangement will improve the sharing of clinical information and patient transfers between the hospitals, according to the press release.
"I know the local community feels very protective of our community hospital and I want them to know, the Board feels that way too," Loux said in the press release. "We spent many, many hours discussing this potential arrangement and feel very confident that this agreement is in the best interests of our hospital and our patients."
