Hospital Hosts a Public Forum on Plan to Join Boston Group

By MIKE SECCOMBE

Island residents who want to hear more and speak out about the Martha's Vineyard Hospital's plan to join Massachusetts General Hospital and its parent company Partners Health Care by the end of the year will have the chance at a public forum this weekend.

Hosted by the hospital and Partners Health Care, the forum begins at 2 p.m. on Sunday at the Tisbury school gymnasium.

Under the terms of the proposed deal announced last month, the Vineyard hospital, along with Nantucket Cottage Hospital, would become affiliates of the giant hospital group, ceding the independence they have enjoyed for 80 and 90 years respectively.

For the Vineyard, the advantages of the deal include a $5 million contribution from Mass General, which will complete a $42 million capital campaign for a new hospital building. It would also result in clinical benefits including direct access to a wide array of medical services, electronic medical records and data transfer and a teaching affiliation with the Harvard medical school.

The hospital would retain its own governing board, name and control of charitable contributions.

In return, Partners would own the real estate, control the hospital budget and have final decision-making authority, although a memorandum of understanding negotiated between the parties guarantees no reduction in services.

Crucial to the deal going ahead is a requirement that either the Vineyard or Nantucket give up its status as a critical access hospital.

Critical access status means the hospitals are fully reimbursed for the actual cost of the services they provide. But because both are high wage hospitals - due to the high cost of living on the Islands - and the complex formula by which Medicare calculates its payments to state hospital systems, their status results in other state hospitals receiving some $250 million less than they otherwise would.

While it seems clear that Partners, as the largest health care provider in the state, would benefit substantially from any recalculation of Medicare payments, questions are expected at the forum on the possible impact on costs to the small hospitals.

Partners is a nonprofit consortium formed in 1994 when Mass General and Brigham and Women's Hospitals merged. Other affiliates include McLean, Faulkner and Newton Wellesley Hospitals.

So far, there has been little public criticism of the plan. Major donors to the hospital capital campaign were consulted before a memorandum of understanding was signed this month, and gave their approval.

Although Massachusetts General is not a union workplace and the Vineyard Hospital is, Eamon Hogan, associate director of labor relations for the Massachusetts Nurses Association, said he saw no threat to his 45 members on the Vineyard.

"We don't anticipate any changes in the collective bargaining relationship," Mr. Hogan said.

"We have a contract in place until September 2008, and even after that I presume that the collective bargaining relationship will continue on as it has for many decades now."

Nurses at Brigham and Women's are currently striking over wages and working conditions.

Harvard Business School professor and part-time Island resident Rosabeth Moss Kanter said this week that the affiliation can only be good for the Vineyard hospital.

"I have nothing negative to say about it," Ms. Kanter said. "I think it's all positive. There is this move for the large hospital systems to bring more and more rural and community hospitals into their orbit. That's a good thing. You need access to much more than you can get locally." She continued:

"Those who want to poke fun at the Harvard teaching hospitals sometimes say Mass General - MGH - stands for Man's Greatest Hospital. But it really is the greatest and the best."

Ms. Kanter cautioned, however, that a small hospital needs to guard against becoming lost in a large system.

"It's often hard to be the small partner. It will require skill on the part of the people who run Martha's Vineyard Hospital because now they are not simply people who run their own domain; they have to be diplomats. They have to be good negotiators. They have to understand complex partnerships.

"I think, though, we have good leadership of the hospital here."

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