On July 7, Baptist Health of Little Rock broke ground on a $130 million, 216,000-SF medical facility off Interstate 40 in Conway, leaving many wondering how the new hospital will affect Conway’s flagship healthcare facility — Conway Regional Medical Center.
Those in attendance at the groundbreaking heard city leaders echo two major proponents for bringing Baptist Health to Conway: population growth and competition improving the health care market.
In his speech at the groundbreaking, Mayor Tab Townsell said Baptist Health Medical Center in Conway is an “insistence that competition shows the strength of the market.”
“You’re showing us the strength of Conway and the strength of this region,” he said.
According to Census data from 2000-2010, the city of Conway grew 36.5 percent with a population of 58,908, and Faulkner County grew 31.6 percent with a population of 113,200.
Using “Arkansas 2020: Arkansas Population Projections and Demographic Characteristics for 2020,” a publication produced by the University of Arkansas at Little Rock, Baptist Health predicts Central Arkansas to grow at a rate of 1.47 percent each year.
By 2020, Faulkner County could grow to a population of more than 154,000.
Faulkner County Judge Allen Dodson said having two hospitals wasn’t necessarily the goal, but it’s the effect of having a great place to work, play, worship and raise a family.
Having both Conway Regional and Baptist Health will give the region the potential for future growth, he said, and is a reflection of past growth.
“Faulkner County’s population has increased dramatically over the past 20 to 30 years and Conway Regional has been able to keep up with the demand for health care,” said Conway Regional Medical Center President and CEO Jim Lambert.
Since 2000, Conway Regional has added a women’s center, open-heart surgery, built a rehabilitation hospital and an imaging center.
“We had the ability to do that as a single hospital over the last 20 to 25 years, and in my opinion we would have been able to do that over the next 25 to 50 years,” Lambert said.
Lambert said the population increase may provide an opportunity to build a second hospital, but it doesn’t necessarily mean there is a need for a second hospital.
When accessing the population growth, the average age of residents in Faulkner County is 25, Lambert said.
“That’s not a population that’s using a lot of health care,” he said. “The demographics of our population are so young. I don’t know if the growth is driving health care. It’s driving the economy, but if it’s growing at a young age its not necessarily high utilizers of health care services.”
Conway Regional’s admissions have stayed relatively flat since 2007, despite Faulkner County’s growing population.
“The number of people accessing health care out of our market share is not growing,” Lambert said.
“We can track how many people out of our market share got a hospital stay in a year and how many we got, so our share of that market is staying the same and our admissions are staying relatively the same, that means to me, the total pie or market is staying the same as far as hospital admissions,” he said.
Lambert said he thinks these numbers are caused by the technological advancements in health care as well as an increase in preventative care.
“I don’t see hospital admissions in our market growing despite population growth,” he said.
Baptist Health President and CEO Troy Wells said Baptist Health is building a hospital in Conway to not only serve Faulkner County, but the four to five surrounding counties including Perry, Conway, Van Buren, Cleburne and White.
Conway is a natural funnel for the communities to the north, Lambert said, and Conway Regional has always served those communities.
“We’re going to work hard to keep their trust and earn their choice,” Lambert said.
Wells said he sees Baptist Health’s presence in Conway as a “regional partnership.”
“Our ability to impact health and well being depends on our ability to work with other organizations and hospitals some times that means government, schools . . .”
At this point, Wells said, he could not comment on a collaborative partnership with Conway Regional because of the hospital’s affiliation discussions with St. Vincent Health Systems of Little Rock.
In May, the Conway Regional Health System Board of Directors announced plans to enter into “exclusive strategic affiliation discussions” with St. Vincent.
Lambert said it’s hard to speculate what a collaborative partnership might look like between Conway Regional and Baptist Health, but for example he said he’s heard the hospital is talking about not having an open-heart program to start with.
“I could see them possibly wanting to send their heart patients from their cath lab to [Conway Regional] versus sending them down to Little Rock — that would be a collaboration,” he said. “Whether we do that or not I don’t know.”
Lambert said he’s curious to see if Baptist Health will use their Conway facility to stabilize, treat and transfer to a larger hospital in Little Rock or if they’ll grow the hospital to offer as many services as some of their larger hospitals in the capitol city.
Wells said Baptist Health Medical Center – Conway will be a full-service community hospital.
“Patients will not have to leave Conway for care,” he said. “The strategy is not to get them in and send them to ‘Big Baptist.’”
Although Baptist Health Medical Center – Conway will be a full-service community hospital, Wells said, it doesn’t mean Baptist Health will be able to meet every need at that facility.
For example, with a Level III trauma-center emergency room, Wells explained, it must be understood that some of the more seriously injured patients will have to be transferred to another hospital.
“[The Arkansas State Trauma System] will tell us where they must go for care,” he said. “They won’t be able to stay [at Baptist Health Medical Center – Conway] for that level of trauma care.”
So far, Baptist Health has not indicated what services will be offered at the new facility. Wells said the services would be dependent in part on the physicians that make up the staff.
“Over time the physicians we’re working with will help determine what services will be provided,” he said. “We’ll evaluate the services that are not being met locally that could be, and those that are not being met well.”
Wells said he could not speculate if Baptist Health patients who needed services not offered at Baptist Health Medical Center – Conway would be sent to another Baptist Health facility in Little Rock.
“Those decisions are made between doctors and patients,” he said.
Lambert said having two 150-bed hospitals isn’t the same as having one 300-bed hospital in terms of the services they can offer and the economies of scale they have.
Lambert said splitting patients between two hospitals, that could potentially offer the same services, could result in more patients having to go to Little Rock.
For example, Lambert said, if open-heart surgery patients are split between the two hospitals, and open-heart surgery is no longer a viable service for Conway Regional, from a quality and cost perspective, the hospital may have to stop providing that service.
“Instead of losing half the patients, the community would lose all open heart surgery patients,” he said.
Wells said in any community and in any case, competition will make the end result better.
“There’s always competition,” he said, “even within Baptist Health, but at the end of the day we’re trying to make health care better in this community.”
Lambert agrees that competition will improve the market, he said, but bringing Baptist Health to Conway won’t change Conway Regional’s focus to provide high-quality compassionate care everyday regardless of “who’s across town,” he said.
“We’ve already been competing with them for the past 75 years,” he said, “so we feel like we already compete with them on a daily basis. They’re only 20-odd something miles down the road.”
“If it increases our focus on improving, then we haven’t been focused enough,” Lambert said.
Lambert said bringing Baptist closer might mean the two hospitals will have to disperse additional resources on advertising and marketing — resources that could have been used for health care.
Two hospitals will be a major change for local physicians, giving them more options and the challenges that come with it.
“People like choice,” Lambert said. “Competition is the American way, and people like that and see it as a positive, but it could also have some negative outcomes that aren’t necessarily going to be that advantageous,” he said.
Local physicians will have to make their rounds at two hospitals when they’ve been accustomed to just one, Lambert said.
“They will have to learn the systems and process of two different places, but on a positive note they will have choices,” he said.
There’s going to be pros and cons that come out of having a two-hospital town, Lambert said.
For example, Lambert said, access to physicians and health care is an issue, and a second hospital may bring more doctors into the community, but it may make it more difficult to recruit because a lot of doctors liked coming to this community because it only had one hospital, he said.
Lambert said he expects the majority of doctors will cover both hospitals, but there are doctors within the same practice who are divided on whether Baptist Health coming to Conway will be a positive thing for the community.
“If one of your partners wants to go to [Baptist Health] and do cases, then either you break up the group or you agree to cover, and I think most of them will agree to cover,” Lambert said.
Dr. Benjamin M. Dodge, an orthopedic surgeon of Conway, said at the groundbreaking on July 7, that Baptist Health Medical Center – Conway was a culmination of many years of hard work by a core group of physicians.
“This group of physicians has worked closely with Baptist Health and its administration to help get us where we are today,” he said. “We have been impressed with Baptist Health’s integrity, we’ve been impressed with Baptist Health’s insight into the health care needs of Arkansans and we have been impressed with Baptist Health’s professional manner and how we’ve worked through this process.”
Lambert said he doesn’t see those physicians “mass exiting Conway Regional.”
Wells said he expects some physicians to practice exclusively at Baptist Health and some physicians to continue to practice exclusively at Conway Regional.
“Others will maintain privileges at both, going back and forth, along with the challenges that come with it,” he said.
With health care reimbursement transitioning from a fee for service system, in which providers such as Medicare and Medicaid pay based on the number of services, to a system where providers are paid based on improving outcomes, hospitalization will not necessarily be the best way to manage care.
“The goal of that is if I’m going to get ‘xyz dollars’ and I’m supposed to take care of your healthcare,” Lambert said, “I’m going to try to keep you well, I’m going to try to keep you out of the hospital and I’m going to try to make sure you take care of yourself.”
Looking at the future, nationally, healthcare is moving toward population health management, accountable care and bundled payment, putting hospitals and providers at risk for all of the community not just patients, so providers must consider managing a community’s care across the continuum.
“You have to keep your costs down so you can make sure you can manage risks and you want to keep people in environments that are less costly,” Lambert said, “and the hospital is the most costly environment you’ve got.”
With Arkansas being the third most obese state in the nation, both Conway Regional and Baptist Health have initiatives in place to promote wellness and fight obesity.
Conway Regional Health & Fitness Center is considered one of the largest hospital-based fitness centers in the nation at 70,000 square feet and with more than 7,000 members.
Baptist Health partners with churches in the community to provide health promotion and prevention activities to medically underserved, uninsured and underinsured individuals through their Baptist Health Community Wellness Center initiative.
Wells said Baptist Health plans to improve the health care and well being of the community by providing faith-based health care and working closely with physicians and patients in clinics, hospitals — “ and not just in the hospital walls, but in their homes,” he said.
Baptist Health Medical Center – Conway is projected to open in the first quarter of 2016 with 96 beds, eight operating rooms and a Level III trauma-center emergency room.