Is Bigger Healthcare Better?

Philip Betbeze, for HealthLeaders Media , April 13, 2012

Lupica's not buying it.

"I try to take a neutral approach by talking about confidence," he says, of being called in to consult about a facility's strategic direction. "Never before have community hospitals, especially in rural areas, had a greater opportunity to apply the benefits of technology to integrate, coordinate, and provide better unified care, without passing the deed around the table."

He may be right about that, but in some ways, it's easier to do a merger than do the hard work of staying independent. Certainly, the prospect of soldiering along on your own doesn't get the news headlines, he admits.

"What doesn't make the news is the dedicated CEO and team coming up with an affiliation with a local university to operate a stroke program, for example, or other strategic alliances that allow you to stay independent. To a hammer, everything looks like a nail," he quips.

"Lots of Ways to Bring in Capital"
But many of these organizations are capital-starved, I argue. How are they going to pay for the new EMR system, the extra labor necessary to manage patients? How will they make a smooth transition from fee-for-service reimbursement to value-based? How will they not get frozen out of employers' narrowing networks without a big corporate parent to rely on?

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