When Williamsburg (Va.) Community Hospital put up a "for partnership, affiliation or sale" sign in January, it pitted a mix of national and regional systems against each other.
At Williamsburg Community's request, Columbia/HCA Healthcare Corp., Bon Secours Health System, Sentara Health System and Riverside Health System last month submitted proposals explaining why the 139-bed, not-for-profit hospital should join their respective folds.
The multistate chains of Columbia, based in Nashville, Tenn., and Bon Secours, based in Marriottsville, Md., are competing in the backyards of Sentara and Riverside, which have focused on building regional networks in Virginia. Sentara is based in Norfolk, and Riverside hails from Newport News.
Leslie Donahue, chief executive officer of Williamsburg Community, said a decision on the preferred system and the nature of the agreement won't be made until the end of April.
"Our minds are still open," he said.
Donahue said the ideal partner would provide Williamsburg Community with access to managed-care contracts, capital resources, a strong information system infrastructure and opportunities for physician integration. The agreement could take the form of a loose affiliation, a partnership in which equity is shared, or an outright sale, he said.
Members of the hospital's task force on affiliations currently are hashing out where the control of the hospital's board should lie and whether the hospital should keep its tax-exempt status. Of the systems vying for Williamsburg Community's hand, only Columbia is for-profit.
The one option that appears to have been ruled out is maintaining the status quo. "It's clear that with an alliance we can create some cost efficiencies and get access to managed-care contracts," Donahue said. "As an independent solo hospital, it would be difficult, if not impossible, to do that."
At the same time, Bon Secours is pursuing an affiliation with another Virginia not-for-profit hospital.
Mary Immaculate Hospital in Newport News is in negotiations with the system, according to a spokeswoman for the hospital. Mary Immaculate's facilities include a 110-bed hospital and a 115-bed nursing home.
The spokeswoman said the hospital is not talking with any other systems and that no deadline has been set for the talks with Bon Secours.