Samaritan, Confluence officials answer affiliation questions

MOSES LAKE — About 15 community members attended an open forum Tuesday evening at Samaritan Hospital to learn more about and provide feedback on the organization’s proposed affiliation with Wenatchee-based Confluence Health.

Samaritan officials planned the special forum after the Board of Commissioners for Grant County Hospital District No. 1, which owns and operates Samaritan, approved a memorandum of understanding (MOU) last week for affiliation with Confluence. The MOU outlines the structure and governance the proposed affiliation will take, if it is eventually finalized. The Board of Directors for Confluence Health, which is a non-profit organization, also approved the MOU last week.

Samaritan CEO Theresa Sullivan kicked off Tuesday’s forum with a presentation explaining why Samaritan and Confluence are proposing an affiliation and what the affiliation will look like, based on key provisions in the MOU. Confluence CEO Peter Rutherford was also on hand at Samaritan to provide commentary and answer questions from the public.

At the forefront of reasons for affiliating is what Sullivan called the “Triple Aim” of health care. The three pillars of the Triple Aim are improving patient experience (including outcome and quality of care), improving the health of the population, and reducing costs of health care in the process. Sullivan said together, Samaritan and Confluence can accomplish that goal much more efficiently by providing high-value care and expanding services in Moses Lake.

Part of what drove affiliation talks in the early going was the changing landscape of health care and how it is paid for, Sullivan said. Take Medicare, for instance, which accounts for one-third of Samaritan’s payment system: according to information in Sullivan’s presentation, the average couple retiring in 2005 paid $140,000 in taxes during their working lifetimes into Medicare. Though that may seem like a lot, Sullivan said the same average couple received $390,000 in Medicare benefits, almost three times their contribution in taxes.

The state of Medicare and its funding points to several things, including that the population is getting older and more importantly, that health care reform is imminent.

“No matter what happens with our elections this year, health care is not sustainable … to stay the way it is,” Sullivan said. “Even if something changed with the election, we still can’t continue the way we are with health care.”

The way health care is provided is changing as much as the way it is being paid for, Sullivan said, so the reasons for affiliation are plentiful. Together, Samaritan and Confluence can evolve more efficiently and effectively to provide the best care to Moses Lake and Grant County residents at the best value.

“We would like to be able to optimize and expand services in Moses Lake,” Sullivan said. “And I would argue that we can’t do any of these things alone.”

The MOU that was approved last week by both organizations lays the groundwork for the proposed affiliation. The memorandum defines that the affiliation will take the following shape: Grant County Hospital District No. 1 will lease all of its real estate assets, including Samaritan Hospital and clinics, to a new company that will be formed as a subsidiary of Confluence. The Hospital District will oversee the lease, and the new company will operate as part of Confluence’s network in north central Washington.

Next, the organizations will enter into negotiations to form the details of what the affiliations will look like — things like strategic planning, financial plans, operational details (space planning, facilities, service changes or additions, etcetera) and more. Sullivan said Tuesday night that the process of defining those details will take at least several months. She said an “optimistic timeline” for the affiliation being complete and official is the end of this year, but it could likely be sometime beyond that.

Rutherford and Sullivan responded to a handful of questions and comments from the small audience Tuesday night regarding various topics, including Hospital District tax dollars, diversity of services, urgent care facilities and the Samaritan Foundation.

Sullivan explained the Hospital District will still own its properties and facilities, but will lease them to the new Confluence division in Moses Lake. Expenditure of tax dollars received by the district will require approval from the commissioners. Sullivan also said the Samaritan Foundation will remain a separate entity and contributions to the Foundation will continue to stay local.

The bottom line, Rutherford explained, is that the proposed affiliation will allow both organizations to be more effective, which will bode well for local residents who want high-quality care and diversity of health care services at lower costs. Changes in health care are coming one way or the other, he said, so by coming together, Samaritan and Confluence can evolve with the times and help drive that change.

“We have been kind of friendly competitors over the years,” Rutherford said of Samaritan and Confluence. “(It is) time to figure this out and how we are going to integrate this and how we are going to do it so that we get all the waste out — and that’s how we will reduce the costs. That’s really the challenge and the work that we need to do and that, to me, is the big reason to the do this.”

One respondent at the forum voiced concerns that the affiliation felt more like “a Confluence takeover.” Sullivan said what is happening is more along the lines of conjoining efforts for the betterment of health care in Moses Lake.

“To me, what you have here is two organizations coming together saying, ‘we can do better for health care in Moses Lake and in Grant County’ – not a takeover,” she said.