As teaching hospitals sign partnership agreements with other healthcare providers, many longtime alliances of medical schools and other teaching hospitals are being uprooted.
For competitive reasons, hospitals are revamping such alliances to protect their turf. And medical schools, concerned about the cost of training residents, are courting hospitals with the financial stability and operational smarts to survive the competitive onslaught.
This month, the board of Catholic Medical Center of Brooklyn and Queens, a 1,104-bed system that includes four acute-care hospitals in New York, voted on whether to retain its affiliation with Cornell University Medical College, which is affiliated with New York Hospital's integrated delivery network. The board will announce its decision sometime this month, a spokesman said, but sources said that, for competitive reasons, the board has selected Albert Einstein College of Medicine.
Last month, Pennsylvania State University's Milton S. Hershey Medical Center in Hershey, Pa., said it would phase out residency training programs at 402-bed Harrisburg (Pa.) Hospital, ending a relationship that began in the 1970s (July 4, p. 6). Hershey is collaborating with Holy Spirit Hospital in Camp Hill, Pa., to create an integrated delivery system. As part of that project, it will renegotiate all its residency training contracts and may start a new family and community medicine residency at Holy Spirit.
These are the latest examples in a growing trend by teaching hospitals and medical schools to pick the right partners for the future.
A variety of medical school affiliations are in place in New York City, according to a Greater New York Hospital Association survey. Although survey results didn't indicate whether hospitals changed medical school affiliations after joining a network begun by an academic medical center, observers said that's what is happening.
The breakups and marriages in New York began with Beth Israel Medical Center's decision six months ago to sever ties with Mount Sinai School of Medicine and sign on with Albert Einstein, said Evan Polansky, president of Premier Healthcare Alliance of New York. Beth Israel is creating a health network that will compete with the system Mount Sinai Medical Center is building.
"Hospitals*.*.*.*need to protect their referral base," Mr. Polansky said. For medical schools, the issue is the cost of training residents. "They've got to ensure they have relationships with the right hospitals," he said.
Although statistics weren't available, industry experts said the formation of hospital networks has resulted in other divorces nationwide.
However, some new hospital networks serve to strengthen existing relationships. For example, two members of Main Line Health System in Radnor, Pa., which is forming an integrated delivery network with Thomas Jefferson University, already had residency programs with the university, which operates Jefferson Medical College and 717-bed Thomas Jefferson University Hospital.