March 9, 2018

Bon Secours and VCU Health are 'fierce competitors'—so why are they collaborating?

Daily Briefing

    Bon Secours Virginia and VCU Health, which have traditionally competed for business, are collaborating on several new ventures, Tammie Smith writes for the Richmond Times-Dispatch.

    Details on collaborations

    The two health systems in September unveiled a new collaborative practice called Bon Secours-VCU Health Thoracic Surgery Associates. According to Anthony Cassano, chair of cardiothoracic surgery at VCU, the partnership between Bon Secours and VCU came about because of an unmet community need for thoracic surgery services.

    The practice has a dual-branded location at Bon Secours St. Mary's, where Cassano now logs several office hours per week. "Every Wednesday we are here sharing clinic and the operating room together," Robert Ferguson, a cardiothoracic surgeon at Bon Secours, said, adding that he also visits VCU "once or twice a week and talk to [Cassano] and our other medical partners there." He explained, "We have our tumors boards both [at St. Mary's] and [at VCU], as well as sharing in the call schedule and rounding on the weekends."

    The two health systems are also collaborating on a pediatric asthma project with HCA Virginia, the Times-Dispatch reports. "Richmond is noted as one of the five top cities as (having a) problem with pediatric asthma and one of the worst places to live if you have pediatric asthma," Toni Ardabell, CEO of Bon Secours Virginia, said. "We are launching the program that will have all of our [EDs] doing the same protocols for pediatric asthma, the same education."

    Overall, according to Ardabell, the two health systems are considering "a good seven or eight [other] possible activities that we can do together. Some of them we will do, and I am sure some of them we won't do." She said that not only does she routinely meet with Deborah Davis, CEO of VCU Health, to discuss potential projects, but employee groups at each organization also meet regularly to brainstorm collaborative efforts.

    Why the systems are collaborating

    According to Davis, the collaboration between the two organization benefits "both health systems and patients." She added, "(Collaboration) allows us to … create a consistency of standard of care, but it also provides ease of access for people who need those services."

    Ardabell added that collaboration makes sense because patient loyalty to one given system is declining. "People will change for access. People will change for money. You can have the best patient experience and the best clinical outcomes, and people will change," she said. "When you consider that you have to think about as we compete with each other for that market, (consumers) they can just be changing back and forth, and we're spending a lot of money competing."

    Ardabell and Davis added that their particular efforts to collaborate are aided by their similar career paths. "Both Toni and I have significant experiences in running both academic medical centers and building community networks," Davis said. "That's a little bit unusual. So that when we're discussing issues, we can actually both talk about either one of those perspectives because of our history."

    Ardabell also pointed out that the health systems share a similar focus on treating underserved populations, making their efforts "really complementary to each other."

    Competition remains

    That said, Ardabell and Davis said Bon Secours and VCU remain competitors. For example, the Times-Dispatch reports, both health systems are establishing their own new medical facilities in the Short Pump area of western Henrico County. VCU in 2016 purchased a 111,000-square-foot building in the area that houses 50 medical specialists, while Bon Secours, less than a mile away, is constructing a 50,000-square-foot emergency care center that will include a 12-bed ED, medical imaging services, and primary care services.

    It "would be really silly to say that we're not [competitors]" said Ardabell of Bon Secours Virginia. "But we are going to compete on quality, price, access, the same things you all compete on. We have to be consumer-centric just like you have to be consumer-centric."

    Davis of VCU agreed. "There are certain spaces where we're competitors. We're fierce competitors," she said. "We wouldn't be in roles as CEOs running major health systems if we weren't fierce competitors."

    Comments

    Rick Mayes, a public policy professor at the University of Richmond's Department of Political Science and co-chair of the university's Healthcare Studies Program, said Bon Secours and VCU's collaborative efforts are a somewhat "lighter" version of a broader industry trend. "The bigger trend, that's similar to this in many metropolitan areas and some rural areas, is large systems are just buying each other out and fully consolidating into one entity," he said. "What VCU and Bon Secours are doing is a lighter version, less intense."

    According to Mayes, some health systems are opting to partner or collaborate with others to keep a competitive edge against larger competitors. He said that when local health systems combine the specialty services in which they excel, they can generate sufficiently high patient volume and care outcomes to compete with centers of excellence elsewhere in the country. 

    Separately, Louis Rossiter, director of the health sector program at the College of William & Mary's Raymond A. Mason School of Business, said the benefit of such collaborations vary based on market factors. "Whether it's good or not depends on the local market," Rossiter said. "As long as patients have other options and the combination does not make for a monopoly, it probably adds some efficiency" (Smith, Richmond Times-Dispatch, 3/2).

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