section header graphic
Search the Health Fund website for:

March 29, 2016 - Kim Moore [see other posts]

Series logo

Rural Options--Third Installment: Merge and Consolidate

Note: this is the third in a multi-part series on strategies for responding to the issues of rural population decline in Kansas communities.

The library at Chaparral High School was full of adults sitting around tables on this particular night in late 2015. Two women were dressed up in Halloween garb appropriate for the season. Jody Gragg from Via Christi Wichita greeted me and quietly explained the goals and structure of the meeting that evening. Representatives of Harper Hospital District #5 and Anthony Medical Center (both located in Harper County) were meeting to continue discussions of a possible merger or other affiliation of the two hospitals. Other Harper County communities were represented and active in the discussion. The meeting was led by a former elementary school teacher who proved herself masterful at understanding the currents and undercurrents in the room. I was impressed by the work coming out of small groups that evening. Instead of a sense of impending loss, there were great expectations of benefits and new possibilities in a shared hospital.

To a considerable degree, these merger discussions have been prompted by the interest of Neal Patterson, Chairman of the Board and CEO of Cerner Corporation and Harper County native, who has offered material assistance for development of a modern health care system in Harper County with only one hospital. With technical assistance from Cerner and Via Christi, the work in Harper County toward a single hospital continues into 2016. A project manager for the merger, Jim Chromik, has been hired to move the work forward. Financial and architectural projections will be forthcoming in a few months. There are, of course, issues to be addressed. At least one is finding an acceptable location which is sufficiently distant from all other critical access hospitals (35 miles) so the new hospital can be designated a critical access hospital (as are the two current ones under more liberal, prior designation rules).

Harper County has had merger experience, as it was an early unified school system with a single high school (Chaparral) located in neither the city of Harper nor Anthony. In my first blog in this series, I noted how my own home community of Longton pulled together with Elk City (across county lines) to form a merged school district. School district mergers have been frequent. Hospital mergers have mostly been limited to intra-city mergers in communities like Newton, Hays, Salina and Hutchinson. This makes the Harper County experience particularly important for all of us. We are perhaps going to see how it can be done, at least inside one county.

It appears that one key to merger work in situations like this is a bottom-line desire that none of the participating communities gains an untoward advantage over the other. Advantages to one community might involve location of the facility, continuing employment opportunities, or unequal control over the new entity’s governance. Using advisors and consultants external to the locale who can adopt and support this even-handed philosophy is something to seriously consider in merger situations. Perhaps it is easiest to consider consolidation and merger when communities are of nearly equal size and the process is more a “merger among equals” versus a “merger of greater and lesser.” Merger talks may also be more successful when organizations are in or facing a leadership transition and existing employed leaders have less concern over their own personal futures.

Organizational mergers would not have to mean “one shared facility.” Theoretically, mergers could be organized to support multiple locations within one corporation or administrative entity. This would permit the sharing of administrative services, medical personnel, equipment, etc. in ways which could reduce costs and perhaps expand services overall. The key would be development of a shared desire for evenhanded distribution of services, employees, and money in response to needs and volume within the system versus allowing local self-interest or governance control by one community to allocate resources. The large investment required for facility upgrades or even new construction coming from different communities in a merged organization would make some mergers difficult where facilities are at different stages in maintenance and reconstruction. The current organization of most hospitals with support from one county makes this type of “multi-facility” merger more difficult, but counties have cooperated together to deliver health care services through regional mental health centers - so it is not impossible. 

Mergers are going to have their place in rural Kansas in the next ten years. They are going to be one path to not only preserve services but also potentially improve services, if distances for consumers are not too great and resulting organizations develop the value of equitable services and economic benefits for all people and communities in the area served. We all need to be watching Harper County to learn from their experience.

Population—Harper County, City of Anthony, City of Harper

1920

1930

1940

1950

1960

1970

1980

1990

2000

2010

2020
PROJ.

County

13656

12823

12068

10263

9541

7871

7778

7124

6536

6034

5441

City of Anthony

2740

2947

2873

2792

2744

2653

2661

2516

2440

2269

City of Harper

1770

1485

1695

1672

1896

1665

1823

1735

1567

1473

Kansas Statistical Abstract 2015

 

2013 Hospital Data

Hospital Beds

Births

Hospital Admissions

Inpatient Days-Hospital

Outpatient Visits

ER visits

Anthony Medical Center

25

0

268

3076

20449

1395

Harper Hospital District #5

25

0

274

3142

36190

2286

2013 AHA/Kansas Hospital Survey
www.kha-net/org/DataProductsandServices/Stat/HospitalUtilization/Hospitals/