The system, located about 30 miles south of Raleigh, has service-line affiliations with Wake County's three big systems: Duke University Health System, Durham, N.C.; Rex Healthcare, Raleigh, which is part of UNC Health Care, Chapel Hill; and WakeMed Health & Hospitals, Raleigh. Johnston Health does not expect the result of the affiliation search to affect these programs, according to the release. The system has had a management-services agreement with QHR, the management arm of Community Health Systems, Franklin, Tenn., for about 25 years.
Johnston Health is exploring deeper affiliation agreements, a joint venture or a sale because the reimbursement climate is worsening, requiring even greater cost efficiencies than the system has already accomplished over the past few years, according to the release. That climate endangers the system's access to capital. The system hopes to add 50 inpatient beds to JMC-Clayton and take other steps that would expand services, increase its market share and improve its financial results, spokeswoman Suzette Rodriguez wrote in an e-mail.
A sale is the least likely of the possible outcomes and would have to win approval from Johnston County commissioners to go into effect, according to Rodriguez. Johnston Health has been studying its options since March.