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Conway Regional prepares for Baptist Health

Posted: July 19, 2014 - 5:47pm

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.

 

POPULATION

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.

 

COLLABORATIVE PARTNERSHIP

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.”

 

SERVICES

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.

 

COMPETITION

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.

 

PHYSICIANS

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.

 

FUTURE

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.

(Staff writer Michelle Corbet can be reached by email at michelle.corbet@thecabin.net or by phone at 505-1215. Send us your news at www.thecabin.net/submit)

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Igor Rabinowitz
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Igor Rabinowitz 07/21/14 - 08:45 am
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Good

What great, well crafted and insightful reporting. Thanks Michelle.

lachowsj
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lachowsj 07/21/14 - 08:50 am
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Competition

Competition among healthcare providers is not like competition between hamburger shops or hardware stores. Studies have shown that, rather than driving down costs, additional healthcare providers tend to drive up demand for services. The cost competition comes from insurance providers who have an incentive to keep their customers well rather than pay for more medical procedures. That is the philosophy behind Obamacare and that will be the thing that slows the rate of increase in healthcare costs.

conwaygerl
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conwaygerl 07/21/14 - 10:00 am
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Ra Ra Obamacare

"Studies have shown that, rather than driving down costs, additional healthcare providers tend to drive up demand for services."

Which studies? I'm betting these studies were funded by EXISTING healthcare providers...wink wink.

Who is driving by the car dealerships and seeing a hospital and thinking, "hey I'm not feeling so good, let's just drive right up"?

lachowsj
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lachowsj 07/21/14 - 12:35 pm
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Here you go conwaygerl

"Changes in consumer attitudes toward health care can also change demand. For example, television, movies, magazines, and advertising may be responsible for changes in people's preferences for cosmetic surgery. Moreover, medical science has improved so much that we believe there must be a cure for most ailments. As a result, consumers are willing to buy larger quantities of medical services at each possible price.
Doctors also influence consumer preferences by prescribing treatment. It is often argued that some doctors guard against malpractice suits or boost their incomes by ordering more tests or office visits than are really needed. Some estimates suggest that fraud and abuse account for about 10 percent of total health care spending. These studies reveal that as many as one-third of some procedures are inappropriate." (http://www.google.com/webhp?nord=1#nord=1&q=health+care+demand+and+suppl... "Applying Supply and Demand Analysis to Health Care", appendix to Chapter 4.)

"Economists and others concerned with health care policy have debated the meaning of 'demand' in health care. After all, as Arrow (1963) emphasized early on, the relationship between patients and their physicians (and other health care providers) involves agency, information, trust, and professionalism. Patients rely on providers to help them articulate their own demand for care. Patients may go beyond this and cede partial or complete authority to providers to make treatment decisions. In health discussions, physicians are sometimes accused of 'inducing demand, which connotes the practice of using influence in the providers' self-interest. A key unresolved issue in health policy is the magnitude of this provider-induced demand, and how it is determined. In this context, the economists' notion of a fully informed and price-taking consumer deciding upon what quantity of health care service to purchase is clearly somewhat off the mark." ("Supply-Side and Demand-Side Cost Sharing in Health Care", Ellis & McGuire, pg. 137.)

"Imagine walking into a boutique and explaining to the sales clerk (working on commission) that you have been a bit blue and are thinking about some new clothes. If you ask the clerk whether or not new clothes will boost your spirits, what response should you expect? Is the sales person likely to say “no” and send you on your way? Of course not. Next, imagine explaining that you will buy whatever clothes the clerk recommends. Should you expect the clerk to point you toward the clearance rack? Of course not. The clerk has a financial incentive to sell you as large and as expensive a wardrobe as possible. The more you spend, the more commission the clerk earns. Historically, the patient-doctor relationship was quite similar. Patients seldom decided what and how much care to buy; their doctors made those decisions. Patients would ask their doctors what they needed and then purchase whatever the doctor recommended. With this traditional fee-for-services provided arrangement, just as with the sales clerk on commission, the more tests and visits and procedures the doctor would recommend, the more income the doctor would earn. The incentive was to recommend or supply as much as possible without scant attention to relative costs and benefits. Could health care providers be so crass? Would they actually prescribe medical care that cost more than it was worth just to pad their own wallets? Some would not, but many would." ("The Joy of Economics: Making Sense out of Life", Robert J. Stonebraker, Winthrop University.)

conwaygerl
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conwaygerl 07/21/14 - 02:42 pm
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ah

Link 1

The increase in demand refers to cosmetic surgery. I don't think the hospital is planning on a large "cosmetic surgery" wing. I might be wrong though.

"It is often argued that some doctors guard against malpractice suits or boost their incomes by ordering more tests or office visits than are really needed."

Argued but not proven.

"Some estimates suggest that fraud and abuse account for about 10 percent of total health care spending."

Key words in order. 1) Some 2) estimates 3) about

Link 2 "In health discussions, physicians are sometimes accused of 'inducing demand, which connotes the practice of using influence in the providers' self-interest. A key unresolved issue in health policy is the magnitude of this provider-induced demand, and how it is determined."

Accused, but not convicted guilty.

Link 3

Your original note stated that healthcare was not like other businesses (fast food, for example).

Then you post a link using a commissioned sales clerk at a boutique as an example.

I've never heard of a hospital employee being commissioned.
Trust me, every MD is salaried.

lachowsj
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lachowsj 07/21/14 - 03:19 pm
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You asked, I gave

Now let's play a new game. Instead of you straining to find the weak points in my references, why don't you try posting some references of your own to bolster your point, whatever that is.

My point was pretty simple and pretty widely accepted, that is, healthcare does not respond in pure supply-demand terms like corn or soybeans. There are other factors at play. I wasn't even trying to convince anyone of that fact, just reminding people of the obvious. You saw the word Obamacare in the original post, so had to charge like a bull at a red cape.

I'm not calling you a bull, just saying your arguments often resemble what a bull excretes.

conwaygerl
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conwaygerl 07/21/14 - 03:33 pm
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First off

No one said it was pure supply-demand. But, I think it's safe to assume that competition is good for Conway/Faulkner county.

If it wasn't, why would CRMC fight it?

"healthcare does not respond in pure supply-demand terms like corn or soybeans."

Agreed, but comparing Doctors to boutique sales clerks IS the very bovine excrement you accuse me of.

fiddlesticks
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fiddlesticks 07/21/14 - 11:39 am
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Circular Reasoning

People that have lived here for a while should read between the lines. Mr. Lambert's comments about how having something like 2 open heart surgery venues would make Conway have no open heart procedures available was such loop de loop reasoning as to be absurd.
Conway Regional has a poor reputation, especially the ER. Many people say they would rather take a chance of dying being transported to Little Rock than go there, myself included. There was a study that showed CRMC was in the top 10 of mortality rates for hospitals nationwide. During the 20 years I have lived here, CRMC has run off every competition that tried to come in, and this will be no different, in fact, I'm taking wagers on how long. Examples: The imaging center on Club Lane was started by a group of radiologists, and CRMC instructed their physicians not to use it and ran them out of business and bought the building. A very good female internist was run out of town about 18 years ago, and now we have one internist in the community. A new oncologist was run off, and also any orthopedist that has tried to come in has been run off as well. So, CRMC's real agenda is that they will covertly manipulate or coerce MD's not to practice at the new hospital and then will purchase the building and we will have 2 CRMC's then.
In Little Rock MD's have priveleges at more than one hospital. Conway's clique-y self-righteous pettiness will bite it in the rear end some day, because there are not enough MD's here to serve the outlying communities. .

Nopenopenope
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Nopenopenope 07/21/14 - 01:25 pm
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The real reason you have no

The real reason you have no internists in town is that they all specialize now. None of them do primary care anymore. Over 90% of primary care work is done by Family Physicians (and they actually do it better, according to studies). If you want internists, start talking to insurance companies who give them incentive to go into lucrative specialties making 3-5x what primary care pays. Only then will you see a return to internists seeing office patients.

fiddlesticks
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fiddlesticks 07/21/14 - 11:41 am
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there

there

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