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March 27, 2009
A Plan to Integrate Healthcare:

Harrington to lease, transition Hubbard Hospital to outpatient facility with 24/7 ER Progress reported on rate negotiation with Fallon Health Plan

WEBSTER/SOUTHBRIDGE, Mass., March 27, 2009 – Three months into a management agreement between Harrington and Hubbard hospitals, both organizations have voted in favor of moving forward with a plan, contingent upon three factors, that would retain adequate and economically viable healthcare in the Webster area. Of the three stipulations, the most pressing involves a negotiation with Fallon Community Health Plan (FCHP) on managed care rates.

The Hubbard Hospital Board of Directors voted Thursday, March 26, in favor of a plan that would enable Harrington Hospital to lease the Hubbard facility and refocus the campus as an advanced outpatient facility. The former hospital would boast technology upgrades, an expanded physician base, ancillary services and specialty coverage, as well as continue to offer 24/7 Emergency Services.

With the new plan, the corporation known as Hubbard Regional Hospital would wind down its operations and be transitioned to Harrington Healthcare at Hubbard.

Three factors must be satisfied in order for the proposal to move forward: An approved lease contract between Hubbard Health Services and Harrington; finalization of state regulations and waivers; and a managed care rate negotiation with FCHP.

Harrington and Fallon held a negotiation session on the rate issue today at which significant progress was made, reported Harrington CEO Edward Moore.

“There is a sense of urgency on the part of both Harrington and Fallon Community Health Plan in order to continue to meet the healthcare needs of the community,” he said. “We have hopes of getting this issue resolved early next week or by the middle of the week.”

Harrington management reached a satisfactory rate with Blue Cross, Blue Shield of Massachusetts in mid-March.

A change in the rate from Fallon would not affect the cost that patients pay for healthcare. The change, if agreed to by Fallon, would increase the amount Fallon reimburses Harrington Healthcare at Hubbard.

Moore stated that if negotiating a new Fallon managed care rate falls through, Harrington will return to the Hubbard Hospital Board of Directors.

“We would tell them this is the only plan we were able to come up with after all the work weve done here. There is no plan B,” he said. “So if we do not get the new rate from Fallon, Hubbard Hospital will limp along until it dies, and Harrington will stay on board through a closure process.”

Reevaluation of Strengths

Since signing the agreement Jan. 1, on-site administrators have analyzed the campus day-to-day operations. Harrington management continually focused on three goals: keep healthcare local, retain as many jobs as possible and look toward a collaborative, long-term healthcare system for Southern Worcester County.

“We are optimistic these changes, if the three contingency factors are met, will allow us to provide quality healthcare services to a deserving community on a long-term basis,” Moore said. “This is a plan we want the community to be excited about.”

“As a board, we never wanted to lose sight of the common goal, which was to continue to provide an adequate level of medical services to this community and be sensitive to the importance Hubbard has played in Webster over the past 80 years,” Hubbard Board Chair Chris Robert said. “I think Ed Moore and his team have done an excellent job at giving the board a grounded perspective while highlighting Hubbards strengths. If we moved forward, this decision would be a major step forward in providing southern Worcester County with a true, integrated healthcare system. We would no longer be competing entities – we are working together to offer critical services across the region.”

Moore first presented details of the plan Feb. 26 to Hubbards Board of Directors.

“The Harrington Board is excited about the possibility of a long-term healthcare partnership with the Webster campus,” Harrington Board Chair Alan Peppel said. “We are supportive of this plan, which will not only keep necessary medical services in the area, but will retain as many jobs as possible to allow for future stability in this community.”

Under the old structure, Hubbard Regional Hospital and Webster EMS were sisters under the parent umbrella of Hubbard Health Systems (HHS). In the new plan, Webster EMS would remain under the Health Systems, which upholds a charitable mission to provide sensible medical services to the Webster community.

The Harrington Board of Directors also voted Tuesday, March 24, in favor of moving forward with the plan, and included encouragement for representation from the Webster community on its board

If the plan moves forward, Harrington will lease the Webster space from HHS, practicing under its own licensure, and continue to grow and enhance many of the outpatient services, including laboratory, cardiopulmonary, physical therapy and rehabilitation, ambulatory surgery, gastroenterology, radiology and sleep lab. As of April 30, the campus would no longer admit patients and the Med/Surg floor would close, effective May 3. It would continue to house a 24/7 ER with inpatient backup at Harrington Hospital.

“From day one we wanted to come up with a way to keep the ER available because its an important resource,” Moore said. “The hope is that people feel comfortable knowing there are hospital beds as close as 12 miles away (at the Southbridge campus) that will be available to them if they need an extended hospital stay.”

Weighing the Impact

The changes proposed are in the best long-term interest of the community and for the entire Southern Worcester County area, Moore said. The decision to close inpatient beds was not one that could have been avoided when examining the inconsistent trend over the past five years.

“Hubbards average census for the last three months is approximately eight to 10 patients per day,” he said. “In exploring which options made the most sense for the future of this campus, inpatient was not one of them.”

Regrettably, Moore said, the decision to close Inpatient will result in jobs lost for Hubbard employees. A total of 48 full-time equivalent employment positions (FTEs) – 66 full and part time staff – would be let go during this transition. The known impact was discussed at length while the team did as much as they could to retain as many jobs as possible.

If the plan is finalized, as many as 101 individuals, nearly two-thirds of Hubbard Hospitals current full- and part-time staff, could have the opportunity to remain employed, either by accepting new or parallel positions through Harrington, or by being integrated into the Hubbard Health Systems organization. In addition, Harrington management would offer outplacement services and job fairs to help those who will not be hired back.

“Its devastating to have to announce any kind of layoff, especially in this economy,” Moore said. “But we are exceptionally pleased that we could retain as many employees as we did. If Hubbards doors closed, all Hubbard employees would be without a job.”

Hubbard has had several years of troubling financial results, a trend the new administration hopes to reverse.

“You have to be realistic,” Moore said. “If we proposed changing nothing and continued day-to-day, based on Hubbards revenue and costs, the hospital would have had to close within three months.”

Harrington was aware of the strict timetable even before signing the management contract in January. An additional sense of urgency came in mid-February when Hubbard received $200,000 from the states Essential Community Provider Trust Fund grant. The hospital had asked for more than $3 million.

“Obviously, we would have loved more. Being granted more money may have bought us a little more time. But its not always about the band-aid fixes,” Moore said. “Sometimes its about leveling the playing field and starting fresh. It might be a smaller field, but its solid and has potential.”

Additional frustration reared its head last summer, when Hubbards campus lost several primary care physicians employed by Fallon Clinic, while Fallons adjoining building drastically reduced their hours of operation. The decisions resulted in massive financial shortfalls for the hospital.

On Stable Ground

Under the new plan, the Webster campus would be overseen by Thomas W. Hijeck, RN. Hijeck joined the administrative team in late February as part of the management contract agreement. Previously, Hijeck was the Chief Nursing Officer at MetroWest Medical Center, and had the same leadership role at St. Francis Hospital in Hartford, Conn.

Hijeck will have responsibilities as the site administrator for the campus, as well as the administrative contact for HHS.

While Hubbard has been exposed to a flurry of administrators over the past several years, Hijeck states that providing the campus and staff with solid leadership is a critical element in maintaining its role in the community.

“Hubbard has been struggling for several years and the turnover of administrators has only made progress more difficult,” he said. “With the implementation of the Harrington plan, healthcare at Hubbard will be on solid footing with the vision to grow services for the surrounding communities.”

The integration between the two healthcare organizations has garnered praise and support from local legislation, as well.

“With the continued fiscal difficulties threatening the existence of Hubbard Regional Hospital, joining with Harington is both inviting and, in reality, necessary,” said Rep. Paul Kujawski, D-Webster. “I am pleased the ongoing efforts to assist Hubbards future — by discussions with executives and board members from both institutions, as well as with State officials arranged by Sen. Richard T. Moore and myself have been productive and will allow for the Webster community to continue to receive quality healthcare.”

“I am confident the merger of Hubbard Regional with Harrington will continue a long-standing history of community-oriented healthcare in Southern Worcester County,” said Sen. Richard T. Moore, D-Uxbridge, who is also Senate Chairman of the Health Care Financing Committee. “In this time of economic duress, a partnership like this is a great example of how thinking creatively can preserve access to essential services in our Commonwealth.”

Encouraging Community Support

Despite the overwhelming changes that lay ahead for Harrington management and HHS if the plan is approved and the three factors met, both organizations stress not only are the majority of services remaining open, but now more than ever is community support the backbone of creating a long and thriving future for the Webster campus.

“These are big changes, and they seem like a lot to our valued patients,” Webster campus PR Coordinator Blaine Moffa said. “But we cant stress enough that this is a collaborative effort between Hubbard Health Systems and Harrington Hospital. Its a truly positive way to begin to integrate a long-term healthcare campus for this community.”

 

A Closer Look

What will stay?

Upgrades:

What will Close?