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All 10 of the organizations have voted to join together under a single financial and operating model overseen by one Board of Trustees.
Portland, Maine – The member organizations of MaineHealth have adopted a proposal to join together under a single Board of Trustees that will oversee a unified financial and operating model for Northern New England’s largest healthcare system.
The last of the entities to adopt a resolution on the proposed “unification” of MaineHealth did so today when MaineHealth’s system-wide Board of Trustees approved of the joining of the member organizations together. The board votes at individual members, which began on Nov. 2 and were taken over the subsequent weeks, follow more than a year of discussions among MaineHealth members and the communities they serve over whether and how to change the healthcare system’s governance model.
The unification proposal is subject to a due diligence review by MaineHealth and its member organizations. Also, the decision to unify by MaineHealth’s member in New Hampshire, Memorial Hospital of North Conway, is subject to review by the Charitable Trust Unit of the New Hampshire Attorney General’s office. Assuming this regulatory approval and no unexpected findings in due diligence, the 10 members of MaineHealth will be governed by a single Board of Trustees beginning in January 2019.
The proposal adopted by the system’s members includes a significant ongoing role for local boards, including formulating budgets and strategic plans, credentialing of physicians and other providers as well as oversight of care quality.
Susannah Swihart, chair of the MaineHealth Board of Trustees, said MaineHealth initiated the dialogue with its members about changing their governing structure out of concern for community hospitals within the system. “In recent years many community hospitals in Maine, New Hampshire and across the country have struggled financially,” she noted.
Though a number of factors have been squeezing the bottom lines of local healthcare organizations, one of the most significant has been the migration of more complex procedures to major medical centers, which are able to leverage new technologies employed by highly specialized providers.
Across the MaineHealth system this has created uneven financial performance among member hospitals, threatening the ability of some community hospitals to continue to deliver needed care. Meanwhile, Maine Medical Center in Portland, the system’s tertiary care hospital, has seen growth in volume and in its bottom line as complex procedures have migrated there.
A unified governance model would allow resources to flow across the system, better supporting the delivery of care in local communities.
The change does mean ceding many aspects of local control to a single Board of Trustees, however, and that concern generated a good deal of discussion among MaineHealth members and in the communities they serve. All of MaineHealth’s geographically based members conducted outreach into their communities, including one or more local forums open to the public.
As this input was being gathered, representatives from member boards met throughout the year to discuss opportunities and concerns raised about unification. Their goal was a proposal that could balance leveraging the healthcare system’s resources in support of local services while retaining a local voice in the governance structure.
“I think it’s fair to say we were skeptical at the start,” said Clint Boothby, chair of
Franklin Community Health Network, which oversees Franklin Memorial Hospital in Farmington. “We joined MaineHealth in part because it offered a degree of local independence, and people legitimately asked, why give up more local control?”
The answer, said Boothby, is that, with so much uncertainty in a challenging healthcare environment, it made sense to leverage the full resources of the MaineHealth system in support of care in local communities. Boothby also noted that the unification proposal includes an ongoing role for local boards and provisions aimed at making sure that local organizations would continue to have a voice at the system level.
The proposal guarantees MaineHealth’s geographically based members at least one representative on the system board for the first five years. This was a topic of extensive discussion among MaineHealth members, as leaders wrestled with the fact that providing that representation across the system creates a very large board that over time could prove unwieldy. The five-year guarantee, along with an ongoing commitment to maintaining geographic diversity on the system board after that time, was a compromise reached as part of the discussion among MaineHealth members.
Bill Burke, chair of the Maine Medical Center Board of Trustees, said his organization has embraced unification because it is what is best for patients.
“We believe this is how we provide the best care for the 1.1 million people in the MaineHealth service area who rely on Maine Medical Center to be the place that’s there for them when they face the most serious illnesses,” said Burke. “We can’t fulfill our mission as the state’s premier tertiary care hospital without our partners in the communities we serve. Keeping those organizations in a position to deliver great primary and secondary care supports our tertiary care mission.”
MaineHealth is Northern New England’s largest healthcare system with member and affiliate hospitals throughout southern, western and central Maine, as well as Carroll County, N.H. MaineHealth members include Southern Maine Health Care in Biddeford and Sanford, Maine Medical Center in Portland, LincolnHealth in Damariscotta and Boothbay Harbor, Coastal Healthcare Alliance, which oversees Waldo County General Hospital in Belfast and Pen Bay Medical Center in Rockland, Franklin Community Health Network in Farmington, which oversees Franklin Memorial Hospital, Western Maine Health in Norway, which oversees Stephens Memorial Hospital and Memorial Hospital in North Conway, N.H. Three additional members provide services throughout much of the organization’s service area, including Maine Behavioral Healthcare, NorDx Laboratories and MaineHealth Care at Home, a home health care provider. For more information about MaineHealth’s unification initiative go to: mainehealth.org/about/unification.