Mainebiz

V O L . X X I I I N O. X X I S E P T E M B E R 1 8 , 2 0 1 7 30 M aine, with its far- ung largely rural population and the chal- lenges that brings, has always had a tradition of collaboration when it comes to health care services. But changes in the economy, health care policy, care reimbursement, com- bined with the state's aging population, has brought that collaboration to a new level, and health care systems are rewrit- ing the strategy on how to better care for patients and still stay in business. e move to join forces is "heating up," says M. Michelle Hood, president and CEO of Eastern Maine Healthcare Services. Given the challenges, health care "has to be innovative to reach people where they are." Mark Fourre, CEO of MaineHealth's Pen Bay Medical Center and Waldo County Hospital, says much collaboration rises from nding ways to provide the best care while keeping rising costs in check. "As any business owner and our government will tell you, we can't keep putting the amount of money into health care that we are if we want to maintain a healthy economy." at impact is also felt by the state's much smaller health care providers, says Charles Dwyer, of the Maine Health Access Foundation. e makeup of Maine's small, remote communities have always been "a delicate ecosystem" for health care, says Dwyer. at balance has tipped in recent years with mill closings, health policy upheaval, technology changes and other factors. MeHAF is urging communities to ask, "How might a system that's more integrated bene t not only the population's health, but the economic strength of that community?" Dwyer says. e foundation gave , to ve programs in January to help rural health care systems work out plans access and sustainability. While MeHAF's focus is on rural systems, Dwyer says the push to col- laborate is felt statewide. "It's essential for organizations in urban areas as well as rural, large ones as well as small ones," he says. 'Out of necessity' e many issues that are a ecting health care are behind two major MaineHealth collaborative e orts this year. In July, the state's largest health care system announced that a million grant from the Alfond Foundation will fund the MaineHealth Cancer Care Network, a collaboration with a number of Maine providers and Dana-Farber Cancer Institute in Boston. At the same time, the system is working to unify its hospitals and providers under a single governing system and budget. e two moves are di erent types of collaboration, yet are driven by some of the same forces — rising costs, changes in how patients access medical care, systemic changes. Fourre says the leading cause of errors in medicine is a breakdown of communication. e cancer network improves communication between dif- ferent elements of care, which are often found at di erent sites. Among the fea- tures, it will allow patients to communi- cate with providers via video, and they'll be provided a "navigator," who will help them understand and coordinate care. One aim of the program is to allow patients to stay close to home when possible, but still have access to state- of-the-art treatment they may not otherwise have had. Since most small hospitals no longer provide the services and procedures patients need, the network builds con- nections and gives them better access to those services, Fourre says. e ,-employee network's uni cation move is an administrative collaboration, driven by changes in health care reimbursement and the health care economy. While there is concern about loss of local control, it's getting harder for many of the network's hospitals to survive nancially with separate govern- ing boards and budgets, Fourre says. A uni ed system, which must be ap- proved by the boards of the member hos- pitals, would allow revenues to be spread better across the system and resources to be used more e ciently, he says. Maine Medical Center, with its beds, can scale its expenses. But -bed Franklin Memorial Hospital in Farmington, which merged with MaineHealth three years ago, doesn't have that economy of scale. It doesn't o er many of the services that provide revenue for larger hospitals. Smaller hospitals, those with beds or less, can be designated critical access and be eligible for federal grants, but Franklin Memorial is too large. "It's in the middle," says Fourre. "With hospitals like Franklin Memorial and [-bed] Pen Bay, what do you do?" "It's pretty much impossible for a small hospital to stand alone, or even a big one," Fourre says. "Hospitals are coming together out of necessity." P H O T O / C O U R T E S Y O F E M H S P H O T O / C O U R T E S Y O F M A I N E H E A LT H Healthy businesses As access to health care becomes more limited, collaboration is key • • • • - H E A LT H C A R E F O C U S M. Michelle Hood, president and CEO of Eastern Maine Healthcare Services, says given the industry's challenges, health care "has to be innovative to reach people where they are." Mark Fourre, CEO of two MaineHealth hospitals, says 'we can't keep putting the amount of money into health care that we are if we want to maintain a healthy economy.'

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