A major public hospital in Indianapolis will remain independent because of conflicts it would have affiliating with either of the city's two largest healthcare systems.
A primary concern of a blue-ribbon committee, appointed by Indiana Gov. Evan Bayh earlier this year, is how a pending merger between 596-bed Indiana University Medical Center andPublic hospitals
928-bed Methodist Hospital of Indiana will affect 323-bed William N. Wishard Memorial Hospital, a stand-alone facility owned by Marion County Health and Hospital Corp.
"It appears to be the best option for us to remain alone," said Wishard's president, E. Mitchell Roob Jr.
Roob made similar comments last week to the committee, which is investigating whether a proposed consolidation of IU Medical Center, Indiana's only academic medical center, and Methodist serves the public interest.
The IU-Methodist deal would be a merger of the hospitals' balance sheets, governance and leadership, creating a corporation with a common chief executive officer (June 19, p. 20).
Because the IU medical school manages Wishard, and the dean of the medical school, Walter Daly, would sit on the IU-Methodist board, conflicts would arise, Roob said.
Wishard had also been considering a formal affiliation with a network led by three area hospitals: 822-bed Community Hospitals and 882-bed St. Vincent Hospital and Health Care Center, both in Indianapolis, and 428-bed St. Francis Hospital and Health Centers in suburban Beech Grove, Ind.
"If we had a relationship with a competing system, it would put the dean and his doctors in an awkward situation," Roob said.
Executives at both networks are concerned that adding Wishard to their deals would create an open-ended indigent-care burden for their systems.
By itself, Wishard has been profitable, but increasing numbers of indigent patients pose a threat to the public hospital. Nearly half of Wishard's 16,000 annual admissions are Medicaid patients.
"Is it a plausible long-term solution for us to be alone? I don't know," Roob said. "We may have to develop tactical relationships with both networks for joint purchasing, programs and inclusion in insurance products."
Concerns have also been raised that Wishard could lose access to paying patients and also forfeit access to IU's specialist physicians. Some 400 IU medical students are trained at Wishard, which also has served as IU's emergency room.