Hartford Business Journal

14 Hartford Business Journal • May 14, 2018 • www.HartfordBusiness.com By Matt Pilon mpilon@HartfordBusiness.com A s healthcare technology and practices evolve, community hospitals are yearning to offer more complex procedures that were once housed only within the walls of their larger competitors. Efforts to add services like robotic and vascular surgery have been made by community hospitals in recent years as they look for more lucrative business lines and to bring care closer to patients. The latest example is Manchester Memorial Hospital, which has jointly proposed with St. Francis Hospital and Medical Center to construct a $3.1 million lab in Manchester that would offer heart-disease patients advanced diagnostic and interventional cardiol- ogy services. They include elective and primary angioplasty, which surgically restores blood flow to blocked arteries using a carefully threaded catheter, and the diagnostic catheterization test that precedes those procedures. Though smoking cessation and statins like Lipitor have driven a longer-term decline in the need for those services, Manchester Memorial executives say they expect demand to continue crawling upwards due to an aging population. Connecticut hospitals performed 23,925 angioplasties and diagnostic caths last fiscal year, up nearly 9 per- cent from two years prior, according to data filed with state regulators. Manchester Memorial, which is owned by California-based Prospect Medical Holdings Inc. and part of the Eastern Connecticut Health Network, estimates it could grab 929 cases an- nually once its facility is fully open. That would translate to about $8.4 million in new revenue and $2.3 mil- lion in additional net income, the hos- pital estimates. The project still needs state regulatory approval. "This is a service that brings in seri- ous revenue," said Dennis McConville, ECHN's senior vice president, chief strat- egy officer and formerly a cardiac nurse. Dr. Dennis Diver, chief of cardiol- ogy and director of the cardiovascular service line at St Francis, would be medical director of the new Manches- ter lab. Diver said St. Francis views Manchester as a key ally. "They're an important clinical part- ner of ours and there are some ben- efits to the patients having [services] locally," Diver said. The two hospitals previously worked together for about a decade to offer diagnostic catheterization at ECHN's Rockville General Hospital campus, which ended around 2012. The program had a good safety record, but not having angioplasty to accompany the diagnostic offering ultimately led to the service line be- ing discontinued. Manchester Memorial has been wanting to offer the diag- nostic tests along with angioplasty for some time, McConville said, but needed capital. Prospect's acquisition of ECHN in 2016 helped make the project possible. He said Man- chester Memo- rial needs the expertise of St. Francis because it's a high-volume provider of such services and can arrange to treat more com- plex patients and provide emergency coronary bypass surgery, if needed. Some Manchester Memorial cardi- ologists are on St. Francis' staff and already practice the procedures at the larger hospital in Hartford. Manchester Memorial would pay St. Francis an undisclosed one-time fee for its help developing the lab, as well as $250,000 a year in ongoing fees. St. Francis would also receive refer- rals of more com- plex or higher- risk patients, and the arrangement could lead to other future part- nerships, officials said. In addition to business consid- erations, Man- chester Memorial says its patients have to travel too far — often to Hartford — to receive such services. In some cases it can take patients 30 min- utes or more to access emergency heart angioplasty. Its service area also has a higher- than-average incidence of heart disease — about 9 percent of adults suffer from it. While a number of community hospi- Branching Out Community hospitals add complex procedures amid push for higher revenue, improved patient access Manchester Memorial's proposed cardiac services Diagnostic catheterization: This is how doctors diagnose any heart problems. The process involves passing a catheter to the heart to look for prob- lems with heart function, valves and blood vessels. Elective angioplasty: Of the three, this service is the most rare in hospitals that don't have open- heart surgery available on-site. It is a scheduled procedure that uses a balloon to open up a narrow or weak artery to improve blood flow. It often involves the insertion of a stent to keep the artery open. Primary angioplasty: This is similar to an elective angioplasty, but is done in an emergency situation, like when a patient arrives in the emergency room during a heart attack. As this procedure has the best outcomes when it is performed as soon as possible, more community hospitals have been approved to offer it than elective angioplasties. Manchester Memorial's proposed cardiology partnership with St. Francis Hospital and Medical Center would bring together two teams that previously worked with each other for a decade. Pictured in a St. Francis cardiology suite in Hartford are several team members, including Manchester Memorial cardiologists Dr. Saquib Naseer (left) and Dr. Chandra Sachetti (right). St. Francis cardiology chief Dr. Daniel Diver (center) would oversee the partnership. HBJ PHOTO | BILL MORGAN

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