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November 14, 2018

'No plans to consolidate': How one community hospital has remained independent for nearly a decade

Daily Briefing

    Nearly a decade ago, Saint Anthony Hospital in Chicago took a risk, separating from Ascension to strike out on its own—and the hospital so far has largely been able to stay in the black, Maria Castellucci reports for Modern Healthcare.

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    Bucking the trend

    Nine years ago, Saint Anthony's board voted to leave Ascension.

    Guy Medaglia, who's been CEO of Saint Anthony for eight years, was a consultant for Saint Anthony at the time. Medaglia said the decision was a "risk" for the hospital, but he "really did believe that we could make it happen." He added, "There were a lot of bets out there that Saint Anthony wouldn't be able to make it past two years, let alone nine."

    According to Castellucci, over the past nine years, Saint Anthony has reported an operating loss once in FY 2016, when Medicaid funds weren't dispersed. The hospital rebounded, reporting a $1.12 million in operating gain in 2017.  

    Being a true 'community' hospital

    Health care financial experts credited Saint Anthony's success to the hospital's understanding of its role as a community hospital as well as its approach to partnerships.

    For example, Saint Anthony has a well established a community wellness program that offers no-cost mental health services, health education, and wellness screenings at three local community centers. The hospital recently received a $1 million grant to add therapists and community organizers to the community to help victims of violence.

    In addition, Saint Anthony leaders are present to offer support if violence occurs in the community. Jim Sifuentes, SVP for mission and community development, said, "If there is a prayer service in the community, it's not unlikely you will find someone from Saint Anthony there. I've been at a prayer service at 12 a.m. where violence happened."

    The hospital plans to further invest in the community through a new hospital building  that is scheduled to open in 2021. The hospital will have 150 beds, private rooms, and an outpatient clinic, as well as 250,000 square feet of shopping, child care, an education center, and a recreation center, Castellucci reports.

    Medaglia wants the new building to be a "hub" where the community can socialize and throw events, such as weddings and birthday parties. But, the hospital has no plans to grow any larger. According to Medaglia, "150 beds are about right for our community with more emphasis on outpatient."

    Entering successful partnerships

    While Saint Anthony focuses on community engagement, it also works with other local hospitals, including Mount Sinai, to ensure patients get the specialized services that Saint Anthony doesn't provide, Castellucci reports. "We don't have heart surgery, and we aren't a cancer center; we are a community hospital," Medaglia said.

    Medagalia said he views Saint Anthony's relationship with Mount Sinai as an "informal" partnership. Saint Anthony transfers its trauma cases to Mount Sinai, and Mount Sinai, which doesn't have a pediatrics unit, transfers its pediatric patients to Saint Anthony.

    Saint Anthony also has formal partnerships with University of Illinois Hospital and Health Sciences System, the University of Chicago, and Northwestern Medicine, which allows Saint Anthony to connect its patients with additional specialty services, according to Medaglia. 

    For instance, neurologists from Northwestern Memorial Hospital offer telestroke services in Saint Anthony's ED every day.

    But while Saint Anthony has successful partners now, the community hospital encountered some surprises when it first tried to establish partnerships. One system turned away patients who were undocumented or Medicaid recipients, which make up at least 40% of Saint Anthony's patient population.

    "We learned our lesson," Medaglia said. "Now we do our references with these people to make sure, (or) do they just talk a good game?"

    No plan to consolidate any time soon, CEO says

    Medaglia said Saint Anthony has no plans to consolidate and will remain independent for the near future.

    "When you are independent ... the only people we owe are our vendors and our employees and it allows us to do more work in the community" (Castellucci, Modern Healthcare, 11/10).

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