A loss of local control, loss of coordination between health care providers and the loss of access to care by the poor – these are the big concerns of Colorado Springs health care leaders as a citizens’ commission decides the fate of Memorial Health System.
In interviews and in testimony before the commission, these leaders all have tried to send the same message: This isn’t just about Memorial Health System.
To them, it’s also about maintaining an unusually high level of collaboration between CEOs of area health care organizations, “safety-net” clinics and physicians.
It’s about retaining local control, because, in their view, health care is a community concern.
And it’s about preserving access to care for the uninsured.
“I think we’ve all said the same thing,” said B.J. Scott, CEO of Peak Vista Community Health Center. “I think (the commissioners) have started to notice that we have some concerns, that this affects the entire community.”
Scott was appointed to the commission, but resigned because she felt Peak Vista’s close relationship to Memorial might present a conflict of interest.
The city set up the commission to help decide whether to sell the hospital or restructure it in some way so that it ends up as an independent entity rather than continue to pose a potential liability to taxpayers should it run into financial trouble.
Peak Vista is among the many health care providers in the region that depend on Memorial as well as Penrose-St. Frances for various services – items such as lab tests that can’t be done at its primary-care clinics.
“What’s the point of going to the doctor if you can’t get lab work?” Scott asked. “We’ve worked to build that relationship, and we’re concerned that access could be cut off,” if Memorial, say, is sold to for-profit hospital corporation.
Scott also is worried about what might happen to Community Health Partners, a nonprofit collaboration made up of hospital CEOs, clinic owners, health care providers and others interested in health care in the region. The group works to create a level of cooperation between providers in the city that is rare elsewhere in the nation.
“Whenever I tell other people in other places that we have a group where CEOs pay dues to be part of this organization to see how we can cooperate, how we work to avoid duplication of services, they can’t believe it,” she said. “Denver’s community health clinics don’t have this. Few places do.”
Losing Memorial in the collaborative would hurt, she said
“We couldn’t do what we do now, they’re too large a player,” she said. “And I’m not sure an outside corporation would see the value in cooperating.”
Even the two competing hospitals in town work together on a few items, said Margaret Sabin, CEO of Penrose-St. Francis Health Services.
She points to the hospitals’ collaboration to keep the Pikes Peak detoxification center open as an example. When federal and state funding cuts forced Pikes Peak Behavioral Health Center to close the detox facility, the two hospitals met and agree to pay to keep the facility in operation.
“Without that level of cooperation, I can’t imagine what our emergency rooms would look like,” she told the commission, suggesting those ERs would become much busier with a swelling volume of drug abuse cases.
Carol Schoffstall, dean emeritus of the Beth-El College of Nursing at the University of Colorado at Colorado Springs, echoed those concerns when she spoke to the commission:
“Memorial has been an ongoing partner in the process of educating students,” she said, “providing scholarships in exchange for work, commitment, providing clinical facilities for student-learning laboratories, sharing expertise of staff for classroom and clinical instruction, encouraging staff to mentor students and provide role modeling.”
She urged the commission to consider Memorial’s partnership with Beth-El when deciding options for the hospital’s future.
Schoffstall has strong feelings about the potential sale of Memorial to a for-profit company that go beyond concerns about educating nurses.
“It’s not that a for-profit can’t have good care, but the rationale of for-profits is to make money for the stockholders, and in some cases, administrators,” she said. “Sick people should never be the source of profit to anyone.”
“In my personal opinion, would be disastrous,” she told the commission.
Under Memorial’s current governance model, control is in the hands of the community. Memorial board members are all from Colorado Springs, and its profits are funneled back into the system for health care.
“There is value to local control and governance,” said Carol Walker, executive director of the El Paso County Medical Society.
Walker said retaining local control of the hospital system means having people in place who know the community well.
“You have people who are in touch with the community needs, in this community,” she said. ‘We aren’t the same as Denver, Grand Junction or even Knoxville, Tenn.”
“Health care is local,” she said. “It’s delivered locally and needs to be delivered by people who understand the community, this unique community.”
Scott and others in the industry also are concerned that changing the governance or the ownership of Memorial, could somehow result in limited access to health care for the poor in Colorado Springs.
“(Peak Vista) sees 58,000 people a year,” Scott said. “And so many people don’t even realize there are 58,000 poor people in the community.”
Peak Vista has an agreement with Memorial that allows it to station its staff in the hospital’s emergency room to help enroll patients in Medicaid and other government insurance programs for the poor.
It also has a deal with the hospital’s maternity ward to deliver the babies of Peak Vista patients.
“We can’t lose that access to care,” Scott said. “We don’t need Memorial to be part of a system where it’s just another hospital, just another way to make money.”
The citizens’ commission is expected to submit its recommendations to city council by year’s end. If council decides to sell or restructure Memorial, voters would have the final say on whether to sell the three-hospital institution.