by Chris Chase
Coastal Journal Staff
BRUNSWICK — This is an article in two parts. This first part will cover the history of the clash between Mid Coast Hospital and Parkview Adventist Medical Center. It will also highlight a bit of what is at stake. Part two, which will come in next week’s issue, will go further into the reasoning behind each plan and the stance that each side is taking.
Mid Coast Hospital and Central Maine Healthcare are once again proposing their own separate plans for the Parkview Adventist Medical Center in Brunswick.
The two plans, which are directly opposed to each other, offer two different views and two different futures for the medical care of the midcoast region.
Central Maine Healthcare (CMHC) tells of a stronger Parkview under their guidance, with reduced costs for the area and greater access to more specialists thanks to their larger and stronger organization’s support.
Mid Coast says that a Parkview under CMHC spells disaster for the entire community, with higher costs, worse service, and business being shipped off to Lewiston. Their own plan, according to Mid Coast, is the more sensible of the two, and would lead to a claimed $25 million annual savings for the region if they are allowed to take control of Parkview.
The core of the matter requires a bit of a history lesson. Parkview and Mid Coast have existed as separate entities for decades, and more or less peacefully coexisted up until 1993, when Mid Coast applied to build a new hospital at Cook’ s Corner. The move was intended to consolidate the organization’s Brunswick and Bath operations into one location, in particular the maternity ward.
Parkview, located just five miles away from the location of Mid Coast, opposed this idea, and argued that bringing a maternity unit to Brunswick would duplicate the services they already had, and would therefore spell doom for their maternity unit.
This was the beginning of the first real battle the two organizations had, and it took place before Mid Coast had even been built. The details are complex and the ensuing legal battle was many-leveled, but the end result was Mid Coast got their hospital, and Parkview’s maternity ward, as predicted, slowly lost service until closing down in 2006.
Since then, things have only gotten more complicated and unfriendly between the two, especially once CMHC came into the picture. CMHC first got involved with Parkview in 2002, when Parkview began to use staff from CMHC in their emergency room, as well as giving Parkview a no-interest $5.6 million loan. Then, on May 28, 2008, CMHC filed a letter of intent with the Maine Department of Health and Human Services. The letter indicated the intent to file a Certificate of Need (CON), the first step in a process which would end with Parkview being a subsidiary of CMHC.
Mid Coast directly opposed this plan, and filed their own letter of intent for a CON on August 29, 2008. This letter cited that Parkview was “not a viable entity without significant financial support,” and argued that without CMHC’s involvement and large non-interest loan, Parkview wouldn’t have been able to support itself. Mid Coast argued that this case wasn’t about a simple take-over of a hospital, but of the establishment of a new company in the area with the sole motive of gaining a new market.
The battle didn’t so much as end as it was partially suspended. CMHC’s letter of intent was not followed up by a CON, and eventually the letter expired. Shortly after this expiration, Mid Coast withdrew their own letter of intent. This meant that the state had made no decision in regards to who would end up controlling Parkview, and it was essentially business as usual.
Fast-forward four years: Once again, the battle is over Parkview, and the proposal is much the same as it was then. Only this time, according to Mid Coast, the stakes are much higher and the environment is completely different.
“Healthcare is truly at a crossroads in our country, in our state, in our region, with the cost of healthcare breaking the back of the economy,” said Lois Skillings, the CEO of Mid Coast Hospital. “People are having a hard time. Costs are rising so fast people are having a hard time affording health care, including employers, as well as tax-payers.”
In 2008, when this proposal first came around, Obama had just started in office, the Affordable Care Act hadn’t been passed, and the recession was only in its infancy. Now, four years later, with only small improvements to the economy and rising healthcare costs, the Mid Coast’s stand is that this isn’t about who will control Parkview Hospital, it’s about the future of the mid coast region itself.
The logic behind their assertion is fairly straightforward. Many employers, small business owners especially, have seen their healthcare costs rapidly rise over the last few years. Healthcare in the U.S. costs more than it does in almost any other country, and Maine has some of the highest costs in the U.S. In some cases, businesses have to make the decision between hiring and employing workers, or paying for healthcare. Mid Coast asserts that if CMHC takes control and costs go up, the resulting costs to businesses could have dire consequences for the local economy.
Parkview and CMHC, predictably, take a different approach and have a different view of the situation.
“CMHC is not purchasing the hospital; there is no money changing hands,” said Chuck Gill, vice president for public affairs for CMHC. “It’s really more formalizing the arrangement with CMHC. It tightens the relationship that we’ve had for over a decade.”
Gill argues that the arrangement that they plan on making won’t change a whole lot in the area, and that the only impact the region will see is reduced costs thanks to the resources that CMHC will bring into the area.
Not so, according to Mid Coast. They see it as a clear effort by CMHC to take healthcare decisions out of the community and take control of the area. The duplication of services that will result from CMHC’s involvement will drive costs up, according to Mid Coast.
“The Bath-Bruswick-Topsham area is the smallest area in New England, if not the Northeast, that is trying to keep two small hospitals going,” said Skillings. “We can’t have it both ways. We can’t shrink healthcare and get the costs down and continue to try to have the duplicated wasteful infrastructure that in our area costs $25 million a year.”
Parkview, which is caught in between CMHC and Mid Coast, feels they have a clear choice between the two organizations.
“Basically where we are is, we’ve worked with CMHC for 10 years,” said Randee Reynolds, the president of Parkview. “Four years ago, we talked about doing an acquisition, that we would like to join their system. We wanted to make sure we were in a position to pull that off, basically. Our board has approved the acquisition for CMHC to take over Parkview.”
Reynolds sees a partnership with a larger hospital as essential to the survival of Parkview, and agrees with Gill’s view.
“The reason the board is interested in this is, we understand the economics that you can’t really do a ‘stand-alone’ hospital any more,” said Reynolds. “It’s happening across the country. Everyone is having to affiliate with someone, and our affiliation with them started a long time ago.”
For now, neither plan is going to come to fruition. The final decision on whether or not either plan goes into effect rests with the state. In addition, the public will have a say in the matter, as a public hearing will be held on the issue.
The details of each plan, whether or not the assertions are true, and the true impact of each plan, will be further examined in next week’s article.