Wednesday, November 14, 2012

Public and Catholic hospitals combine after all in Kentucky

Posted By on Wed, Nov 14, 2012 at 1:34 PM

Interesting development in Kentucky, where state official opposition had stood in the way of a merger of a public and a Catholic-operated hospital because of barriers seen in having publicly financed health services controlled by Catholic doctrine, particularly in the area of reproductive medicine.

They've worked out a deal in Kentucky.

This is of interest in Arkansas, where UAMS and St. Vincent Health are talking about a combination of clinical operations. From Insider Louisville on a deal affecting the University of Louisville:

U of L officials announced they’ve chose KentuckyOne which incorporates Denver-based Catholic Health Initative’s Kentucky operations and the former Jewish Hospital & St. Mary’s HealthCare system for a joint operating agreement over Naples, Fla.-based Health Management Services. CHI and HMS were the two systems that replied to a U of L request for proposal last March.

So the CHI merger is not only back, it’s done, though apparently minus U of L having to abide by the Religious and Ethical Directives of the Roman Catholic Church.

... They apparently gave up demands that Roman Catholic bishops have the final say in treatment restrictions and prohibitions while still agreeing to inject huge amounts of money into the 330-bed University Hospital, as well as into university research and physician training programs.

Dr. David Dunn got credit for seeing to fruition nine months of negotiations. Sources Insider Louisville interviewed this morning believe CHI’s need for a guaranteed pipeline of graduating U of L doctors to its rural hospitals part of the JOA trumped its desire to control U of L’s policy on reproductive procedures.

Moreover, officials conceded that the nitty-gritty details of the deal and how they’ll affect the relationship between the religious hospital system and the publicly-funded safety net hospital are far from resolved.

In Arkansas, UAMS officials have said any resulting deal with St. Vincent would place no limits on its reproductive services. St. Vincent has refused to talk much to the press. But many specific questions remain unanswered and not just about abortion, tubal ligations, vasectomies, emergency room rape treatment and birth control. There are also questions about birth control coverage for shared employees and UA policy that protects its employees from discrimination on ground of sexual orientation, a protection the Catholic institution doesn't provide. Some critics question the infusion of public money into a church-controlled institution that itself would be free independently to impose religious restrictions on its services. Read here about the death of a woman who needed an abortion to avoid complications of a miscarriage but didn't get it because of a Catholic directive.

Kentucky may - may - have worked those issues out. Arkansas is just embarking on the study process. The Catholic church is not known for ceding control on issues of principle so it will be interesting to see if, for example, it stands by while Louisville employees receive coverage for birth control pills. Another difference in circumstances would seem to exist with Arkansas. St. Vincent has not been seen here as a source of new money for UAMS. The institutions mostly seem to believe combining some individual departments can be more efficient (i.e., more profitable) than running competing departments.

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