I'm Not a Doctor

A second opinion on the challenges and opportunities facing today's physicians.

Waiting for the doc-hospital resolution in Nebraska

12:01 am, Jan. 20

Kearney, Neb., a town of about 31,000 people, is about a five-hour drive east from Denver and a two-hour drive west from Lincoln, and now in the middle of a national healthcare controversy.

The 40-bed, physician-owned Kearney Regional Medical Center was 42% complete when financing difficulties and failure to make the construction deadlines imposed on physician-owned hospitals contained in the Patient Protection and Affordable Care Act halted the project.

The physician investors, led by Dr. Sean Denney, are now waiting for either an offer they can't refuse or for the reform law to be judicially or legislatively overturned.

Along with the federal law, Denney said the Nebraska Hospital Association, which pushed through an 18-month moratorium on new hospitals in the state, also had a hand in their project getting stalled.

"It doesn't seem the most fair thing ever," Denney said of the physician-hospital balance of power. "They can recruit physicians to compete against us, but we can't build a hospital to compete with them."

The competition in town is the local Catholic Health Initiatives affiliate, 208-bed Good Samaritan Health Systems. Denney said dissatisfaction with the hospital and its surgical facilities played a major part in getting the Kearney Regional project rolling.

In an e-mail, however, Good Samaritan said progress is being made.

"Over the past two years, hospital officials at Good Samaritan have reached out to physicians in the community to develop a more collaborative working relationship," read a Good Samaritan e-mail to Modern Physician. "These efforts include developing an Integrated Leadership Team composed of nine physicians and four hospital administrators to drive hospital decisions, and six clinical operating councils to improve patient care quality and involve more physicians in decision-making processes. Good Samaritan is also building a 160,000-square-foot expansion that will include new surgery suites, endoscopy suites and a comprehensive cardiovascular center."

There was talk about Good Samaritan and Kearney Regional merging to form a "one-hospital, two-campus solution," but it went nowhere. But if Gov. Dave Heineman's recent state-of-the-state address (PDF) is any indication, the two sides will have to settle their disputes among themselves or wait for federal intervention.

The gist of Heineman's healthcare remarks was that Nebraska will move forward with creating a health insurance exchange, but mostly it will be watching the Supreme Court and waiting to see how it rules on healthcare reform before initiating any major moves.

"Another key issue that we face is the new federal healthcare law that raises taxes, cuts Medicare and contains an enormous unfunded Medicaid mandate," Heineman said in his speech. "It is important to recognize that the United States Supreme Court will decide whether this law is constitutional or not by June 29 of this year. … The simple truth is it would be a costly mistake to spend millions of taxpayer dollars to begin implementing Obamacare until the United States Supreme Court makes its decision."

Follow Andis Robeznieks on Twitter: @MHARobeznieks.


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