The nation's two largest alliances are continuing their tug-of-war over hospitals they want to represent in group purchasing and related service contracting.
The latest struggle involves 145 hospitals that buy supplies from American Healthcare Systems' purchasing program through a for-profit subsidiary of the former Health One Corp., Minneapolis.
The hospitals were placed in limbo three months ago when HealthSpan Health System Corp., which was formed through a 1992 merger of Health One and Minneapolis-based LifeSpan, decided to join AmHS' chief rival, VHA, an Irving, Texas-based alliance.
By last week, 71 hospitals with 10,700 beds that had been part of Health Care Purchasing Partners had decided to stay with San Diego-based AmHS, and 74 hospitals with 5,593 beds chose to make the switch and join VHA. Nine of the group's 10 largest hospitals remained with AmHS.
A dollar figure for HCPP's annual purchases wasn't immediately available.
The decisions by the 145 hospitals reflect an ongoing shift of facilities among alliances as mergers continue in the healthcare industry.
Christian Health Services, St. Louis, decided to drop AmHS affiliation last year after it merged with VHA shareholder Barnes Hospital. In 1989, Henry Ford Health System, Detroit, abandoned VHA for AmHS.
HealthSpan, which owns 17 hospitals, and Medica, a Minneapolis-based HMO, will merge to create Allina Health Systems this summer after a federal antitrust review is completed.
In March, HealthSpan and its owned hospitals opted to join VHA over AmHS, which led to an AmHS-imposed July 1 deadline for the hospitals to decide their allegiance. At the time, HealthSpan's chief executive officer, Gordon Sprenger, was chairman of VHA. Mr. Sprenger said the decision to go with VHA was strategic and not based on purchasing-program strengths or his longstanding relationship with VHA.
"There was not a significant difference in costs of goods and services (between VHA and AmHS)," Mr. Sprenger said. "That became a neutral point."
Still, Mr. Sprenger acknowledged he personally mailed letters to all 145 hospitals announcing HealthSpan's decision and suggesting the hospitals join VHA to reap similar benefits.
Since HealthSpan made the decision to join VHA, however, 52 hospitals decided not to take Mr. Sprenger's advice. They left HCPP, which joined VHA through HealthSpan, and signed affiliation contracts with several AmHS shareholders, including Fairview Healthcare Systems, Minneapolis.
"Some have told us they will reconsider their decision in six months, after new (purchasing) contracts are signed," Mr. Sprenger said.
But Monroe Trout, M.D., AmHS' pres-ident, CEO and chairman, said he expected more of the hospitals that joined VHA to switch back to AmHS contracts. "There is a significant difference in prices. Ours are better. I don't care what anybody says," Dr. Trout said.
The former HCPP hospitals signed contracts with AmHS shareholders that ranged from one to five years, an AmHS spokesman said. However, Dwight Winstead, VHA's executive vice president, said those contracts have 60-day escape clauses. "It's highly likely they will move back (to HCPP)," he said.
Affiliated hospitals staying with AmHS include 552-bed University of North Carolina Hospitals, Chapel Hill, which joined through shareholder hospital Hendrick Medical Center, Abilene, Texas; 375-bed Salem (Mass.) Hospital, through EHS Health Care, Chicago; and 306-bed Bergan Mercy Medical Center, Omaha, Neb., through Immanuel Medical Center, Omaha.
VHA represents 1,039 hospitals with 246,000 beds. It has 776 shareholder or partner hospitals. Another 263 hospitals participate in its purchasing program.
AmHS represents 886 hospitals with 137,500 beds. Its 39 shareholder systems own, lease or manage 395 hospitals with 71,000 beds. Another 491 hospitals with 66,500 beds participate in AmHS' purchasing program.