Crowd awaits answers on proposed merger

Retired area contractor Ken Otke of the Coalition for Choice group asks a question during the Dec. 10 forum regarding the possible merger of St. Mary's Hospital with the University of Missouri Health System. He was one of about 300 people in attendance.
Retired area contractor Ken Otke of the Coalition for Choice group asks a question during the Dec. 10 forum regarding the possible merger of St. Mary's Hospital with the University of Missouri Health System. He was one of about 300 people in attendance.

Leaders of SSM Health and MU Health heard more questions and concerns from Mid-Missouri residents Monday night at a public forum on the possible sale of SSM's St. Mary's Hospital in Jefferson City and Mexico (formerly Audrain Medical Center) to MU Health.

SSM and MU Health announced in August they were negotiating the possible sale of St. Mary's and the hospitals' associated clinics, following SSM's decision to leave the Mid-Missouri marketplace.

Leaders of JCMG and the Coalition for Choice have voiced concerns about the effects and legality of the proposed sale to MU Health, and two previous public forums on the subject have seen large crowds. Before the forum Monday night, outside its location at the Special Olympics Training Center in Jefferson City, at least a dozen silent protestors held signs against the sale that read "patient choice is the cure."

Inside, people from the Mid-Missouri communities of Jefferson City, Mexico and Columbia heard comments and answers to questions from MU Health's CEO Jonathan Curtright and Chief Clinical Officer Dr. Stevan Whitt, and SSM's Chief Operations Officer Steve Smoot.

Questions from the audience of hundreds of people included 
concerns about the possibility of increased health care costs, the future of JCMG, whether local health care staff would lose their jobs or face pay cuts after a merger, and what the process was for soliciting potential buyers for St. Mary's Hospital.

A man who did not identify himself asked the question of what hospital leaders' reaction was to studies from the U.S. Health and Human Services Group and the National Bureau of Economic Research on hospital consolidations that show a correlation after mergers with significantly increased health care costs in the affected markets - commonly 10-30 percent, with a maximum of 50 percent.

"It's not actually definitive at this point," Smoot said of academic research on the subject, adding he's contacted the Advisory Board - a Washington, D.C.-based think-tank and health consultant - for information.

Smoot said there's "lots of examples where the integrated delivery network approach that I've described before can have significant savings as well - 15-30 percent savings going forward. I know that's a hot topic. I know that's something people here are extremely worried about."

Curtright added that "we know we're going to have to decrease costs. Society has spoken," though he too spoke more generally in his response, of the share of the nation's gross domestic product that's spent on health care.

Mary Simmons, who said her husband is an ear, nose and throat surgeon at JCMG, asked on his behalf about how MU Health would work with JCMG. "I just don't see that conflict being easily resolved," she said of competition between the two providers.

Capital Region Medical Center President Gaspare Calvaruso answered: "We have a great relationship with JCMG. We've tried to bridge some of those gaps that we've had over the years."

Calvaruso added that from Capital Region's perspective, "we're open to working with JCMG we need every doctor we can get. Our community needs doctors, and we are not going to do anything to try to put that in jeopardy."

Capital Region Medical Center is an affiliate of MU Health.

Whitt said "we have no intention of replacing people" in response to questions from Roger Wise about whether staff would be kept on or would have to reapply for jobs, and whether other community physicians would continue to have staff privileges at St. Mary's.

Wise is a former patient of St. Mary's, adding that "the staff, the physicians saved my life."

A woman who identified herself as Monica and said she's an eight-year resident of Jefferson City, asked why having two hospitals in the community is not sustainable, if all providers would be kept after a merger and more are needed.

Curtright said "there's more than enough hospital beds," but the shortages are in the number of specialists available.

Smoot said in a response to Coalition for Choice member Ken Otke that he could not give much information on the process of soliciting a buyer for SSM, given the on-going nature of the work, but said "it wasn't a fly-by-night process" and there is no other buyer waiting in the wings.

People can provide more feedback and receive more information on the proposed sale at muhealth.org/ssm.