The 12 members of VHA Metro New York-representing 17 acute-care facilities-and their 6,000 physicians are forming an integrated delivery network that would serve the New York metropolitan area.
Three other facilities-Jamaica Hospital, North Shore University Hospital and Winthrop-University Hospital-also have been involved in network negotiations, although they aren't partners in VHA Metro New York, an affiliate of Irving, Texas-based Voluntary Hospitals of America.
The network, if it's formed, would contract with payers to provide service in New York City, Long Island and the northern counties of Westchester, Rockland and Orange.
Its chief competitor would be the 14-member network formed by 1,310-bed New York Hospital. The difference is that VHA Metro New York is cobbling together a voluntary alliance of hospitals, while the acute-care, long-term care, specialty and outpatient providers in the NYH Care Network are sponsored by its Manhattan-based flagship.
Many specifics of the VHA Metro network were hammered out in the past year, and a business plan has been developed, but no timetable has been set for signing an agreement.
There have been initial discussions about financial commitments, but no decisions have been reached.
"There are a lot of very important, sensitive issues just in the process of being discussed," said Frederick D. Alley, president and chief executive officer of Brooklyn Hospital Center and immediate past chairman of VHA Metro New York. "Some things you can't rush."
Mr. Alley said the group is "ready to move" toward development of a network that will provide services for a capitated amount, which would put providers at risk for managing the cost of care. Physicians affiliated with the hospitals strongly support the effort, he said.
Hospital executives and physicians involved in the negotiations flew to California last month to study how healthcare's delivered in a capitated environment.
The four Westchester County-based VHA members already have a head start on creating a network that will work in the New York market. Last July, the hospitals established Westchester Health Services Network, a corporation that enables the hospitals to contract on a direct basis, said Jon Schandler, president and chief executive of White Plains (N.Y.) Hospital Center and the current chairman of VHA Metro New York.
Last fall, VHA Metro New York signed a contract with Chubb Life Insurance Co. of America, Concord, N.H., to serve as the sole provider of managed-care services in the New York metropolitan area for that insurer, he said.
Meanwhile, MODERN HEALTHCARE has learned that 1,446-bed Presbyterian Hospital, a unit of Columbia-Presbyterian Medical Center, wants to become a partner in VHA Metro New York. Presbyterian is a shareholder in the national VHA organization, but it pulled out of the local partnership in 1990 when it was going through financial troubles.
Currently, 878-bed New York University Medical Center is the sole Manhattan-based academic medical center in VHA Metro New York.
Last week, Presbyterian announced it had reached an agreement to affiliate with White Plains (N.Y.) Hospital Center, a Metro New York member.
A New York healthcare executive who spoke on the condition of anonymity said Presbyterian's affiliation with White Plains gives it "another champion at the table" as it seeks to re-enter VHA Metro.