WILMINGTON — Next week New Hanover County will host a public hearing aimed at moving the public conversation about a potential sale of New Hanover County Regional Medical Center forward. County and hospital officials have promised details will be provided on Monday about the advisory group that will help steer the potential sale process — but for now, there’s little information on who will make up the group.
The Partnership Advisory Group (PAG) has been part of the discussion of a potential sale since the initial announcement in July. County and hospital officials have said the group would be developed as the exploration process moved along. Country Manager Chris Coudriet stated last month that the PAG would be formed and would meet at least twice — later reduced to at least once — before the first public hearing on the Request For Proposals (RFP) process. That plan has been scrapped, but Coudriet said most members of the PAG would attend the upcoming hearing.
Crafting the RFP
The RFP process will outline the county’s requirements for a new owner or partner. By state statute, the county must solicit proposals from at least five healthcare companies (although they can solicit more).
Due to the complex and ambitious goals NHRMC President John Gizdic had laid out for the hospital, the RFP process will be difficult. Gizdic essentially hopes to create a “value-based” healthcare model, one that could address the social determinants of health — including employment, nutrition, transportation, and housing — while potentially breaking away from the “fee-for-service” billing systems of the current health insurance model. It’s a shift that’s expected across the industry, and NHRMC is hoping to adapt to it sooner, rather than later. Because value-based health care includes some unexplored territory, authoring a contract that would compel a new owner or partner to live up to Gizdic’s goals won’t be easy, and Coudriet acknowledged in an interview that county staff isn’t capable of doing it on their own.
Read more about the complex goals for the hospital here: Here’s what the ‘uncharted waters’ of NHRMC’s potential sale look like [Free read]
That’s one of several reasons the PAG is important, as Coudriet has said it will include members who will help craft an RFP that not only prevents a new owner or partner from straying from the hospital’s current mission, but that also keeps NHRMC on the progressive path towards value-based care. The PAG is also important as representatives of public opinion, officials have said.
During a press briefing on Friday, Gizdic and Coudriet said the PAG was just being finalized. The two said that a detailed roster won’t be released until Monday, the day before the upcoming public hearing. Right now, the only two confirmed members are Gizdic and Coudriet themselves; officials said while nineteen other members have made definite commitments to join the PAG, hospital staff are still crafting ‘biographies’ and an informational website laying out who the members are, what their backgrounds are, and potentially where they stand on the hospital sale.
Partnership Advisory Group
There were some details available about the PAG, though. The 21-member advisory group will be made up of five members of the NHRMC Board of Trustees, five members of medical staff (which include physicians who practice at NHRMC facilities in addition to advanced care practitioners like physician assistants and nurse practitioners), and nine members of the community. Gizdic and Coudriet noted that overall the members had a “variety of opinions” and that some had been “vocally against considering a sale.” Gizdic emphasized that a subcommittee of the medical staff chose the five staff members and that he had no role in their selection.
The community members include representatives from the clergy, the business community, the non-profit sector, someone with a financial background, and at least one member with nursing experience. Gizdic and Coudriet said they worked to ensure the PAG’s nine community members were demographically representative of the community in terms of race and gender.
While Coudriet confirmed that there was “representation from outside New Hanover County” he declined to provide details. The NHRMC Board of Trustees includes two Pender County representatives, including the staff president of Pender Memorial and the ex officio representative from Pender Memorial’s hospital board. Coudriet could not confirm if either of those trustees would be on the PAG.
Coudriet did not answer if there would be specific representation for the five other counties and several municipalities outside of New Hanover, including Leland in Brunswick County, which sends many emergency patients to NHRMC, and where the hospital has a medical group facility in Brunswick Forest.
Lastly, Coudriet said there was at least one person who — in his opinion — had the expertise to help craft an RFP to mandate the goals laid out by Gizdic and NHRMC. Gizdic noted that NHRMC’s consultant group would not have a seat on the group, but would continue to advise in the process.
Coudriet and Gizdic reiterated some key tenets of the potential process, including that the ultimate outcome could be anything between a complete sale and retaining the current system, with any number of management or partnership arrangements in between. The two stated, again, that there were no secret promises, preexisting agreements, or other deals that would render the process a fait accompli. Gizdic has in past interviews denied that he had any preexisting arrangement with any other healthcare system or a ‘golden parachute’ agreement with NHRMC should a merger or acquisition end his tenure as the hospital CEO.
Concerns, calls to delay process
The briefing took place just as news broke that Wilmington City Council would consider a resolution next week, asking for the county to table the process of requesting proposals for potential buyers or partners for at least a year. Wilmington will consider asking for the delay in order to further educate the public. Coudriet and Gizdic both said they were surprised by the move, saying that what they have laid out represents a long-term plan, with multiple public hearings over a year or more before a final decision is reached.
During the meeting, several members of the press expressed frustration that details on the PAG would only be available shortly before the public hearing. Gizdic said he didn’t believe that the delay in finalizing the PAG had anything to do with Wilmington’s resolution, adding that perhaps city councilmembers didn’t “fully understand the process and everything involved in the state statute.”
Gizdic and Coudriet did acknowledge sentiment held by residents and public figures — including members of Wilmington’s City Council, New Hanover County Commissioner Rob Zapple, and State Senator Harper Peterson — that the process is being rushed.
Both denied the process was either secretive or rushed, and the two laid out the timeline for a potential sale or new partnership.
Timeline, transparency
According to Coudriet, the PAG will take several months to deliver a final report which will serve as the basis for an RFP. If finalized in December, there will likely be a 60-day period for interested parties to respond. Coudriet said he would not expect the PAG to begin evaluating those proposals until late February or March.
In addition to next week’s public hearing, Coudriet said there would be a second public hearing after the proposals were received, and a third if and when a particular deal was moving forward in negotiations.
Coudriet pledged that the process would as transparent as possible. While Gizdic and Coudriet acknowledged that some “competitive information” and “financial details” would be kept private under state law, that the RFP and any proposals would be public. Coudriet noted that he believed interested parties would craft their proposals in such a way as to comply with the desire to keep them public. These documents will be posted on the NHRMC dedicated to the potential sale process (you can find that site here).
The entire process is expected to take at least a year, Gizdic said, but could take longer.
Next week’s hearing
The first public hearing will be held on Tuesday, October 15 from 4 to 7 p.m. in the auditorium at Snipes Academy of Arts & Design, located at 2150 Chestnut Street in Wilmington. New Hanover County Chairman Jonathan Barfield will moderate.
Unlike many traditional public hearings, those who wish to speak can show up and sign up to speak at any time during the meeting and do not need to do so prior the meeting. All speakers will be given three minutes.
Officials expressed their hope that the public hearing would not fixate on the 3-2 vote in September by county commissioners to continue the exploration of a sale, but would instead focus on the future of the process. Coudriet and Gizdic said they wanted the meeting to focus on the “healthcare priorities” of the community.
Send comments and tips to Benjamin Schachtman at ben@localvoicemedia.com, @pcdben on Twitter, and (910) 538-2001
