WILMINGTON — This week the Partnership Advisory Group met for the third time; at the latest meeting, the group began exploring the framework of a Request for Proposals — the document that shapes how the process of exploring a sale or partnership for the New Hanover Regional Medical Center proceeds.
On Wednesday, the Partnership Advisory Group (PAG) met to begin discussing the “goals and objectives” for New Hanover Regional Medical Center (NHRMC). This involves, essentially, translating the hospital’s strategic plan into a RFP that seeks a partner or buyer that would be able to maintain NHRMC’s current operations and pursue its longer-range goals.
The RFP is the first major step for the PAG, after two orientation meetings that helped define what the PAG’s organization (i.e. selecting chairs and co-chairs), what its mission is, how it will operate, and what the basic timeline of its process will be. You can find agendas and presentations for upcoming meetings, along with past meeting minutes (once approved), on the NHRMC website.
The PAG’s six ‘deliverables’
This will be the first of six “deliverables” defined by the PAG’s charter (which you can find here). These six items represent concrete decisions and public votes as part of a process to explore and potentially execute a sale or partnership agreement — the process could also result in maintaining the hospital under local control.
These deliverables and votes will be:
- Identify the goals and objectives for NHRMC to be included in the RFP
- Identify a list with a minimum of five potential buyers or partners to receive the RFP (other interested parties beyond this list are expected to submit proposals, as well)
- After a public hearing on proposals and due diligence, the PAG will vote on a list of two to three partners to research further
- The PAG will decide either to (a) not move forward with exploring a sale or partnership, or (b) pick a preferred partner (or combination of partners) and identify core considerations to negotiate in a letter of intent (LOI).
- While conducting due diligence on a deal, the PAG will also vote to identify key terms and conditions of the agreement.
- The PAG will attend a public hearing on a final draft of a definitive agreement and make two final recommendations on whether that document is in the best interests of NHRMC and the county. The PAG’s final vote will whether or not to support a final definitive agreement.
It’s worth noting that while the PAG’s ‘deliverables’ are geared towards the process of reaching a sale or partnership agreement, the PAG will also dedicate time to considering options that don’t involve new partnerships or outside ownership. According to its charter, “while third parties are preparing responses to the RFP” the PAG will be “reviewing and discussing NHRMC/County options of continuing status quo or completing an internal corporate restructuring and remaining a stand-alone County-owned public hospital (i.e., not moving forward with a third party).” This process may involve multiple meetings, but will not involve a vote — the PAG could vote not to move forward as part of its fourth deliverable.
PAG Co-Chairs Spence Broadhurst and Barbara Biehner said on Wednesday the process will take as long as necessary and, other than statutory requirements for when county commissioners must hold public hearings before official action, there is no official timeline.
Broadhurst said the PAG had no external considerations for the timeline, including the 2020 election, which will see at least two new commissioners to replace current Commissioner Woody White and Commissioner Patricia Kusek, who have both said they will not run for reelection.
County Manager Chris Coudriet said in October to the process could take a year or more. So far, the PAG has meetings scheduled through mid-April, but more will be added as necessary (you can find meeting dates and info here).
Deliverable #1: The RFP
The RFP is designed to give the PAG, along with the county and NHRMC, more information about a potential partner or buyer, as well as to help shape the conversation moving forward. A key part of that is asking potential partners how they will address NHRMC’s key “goals and objectives.”
Those goals and objectives are largely taken from NHRMC’s strategic plan, which includes ten points. On Wednesday, the PAG addressed give of those (the other five are slated for discussion during the PAG’s next meeting on December 5).
The first points, according to NHRMC, were as follows:
- Improving Access to Care and Wellness – Adding to the number and range of care options in the region so everyone can get more timely and convenient care to better manage their health
- Advancing the Value of Care – Improving the quality of care while lowering the cost of it through systems to improve efficiency, safety, and coordination across care providers
- Achieving Health Equity – Eliminating the demographic disparities in healthcare outcomes by targeting the root causes of poor health and partnering with others in the community to develop and support innovative programs
- Engaging Staff – Ensuring that the culture of the organization is continued and strengthened, with a focus on developing and engaging staff and supporting them with job security, competitive pay and excellent benefits
- Partnering with Providers – Supporting the growth of the medical staff through recruitment, medical education, employed and affiliated provider engagement initiatives, and clinical research
According to an update from NHRMC, during the meeting, several issues were raised, including the need for more geriatricians to serve the growing population of older residents, along with efforts to reach women who don’t seek out medical care on their own, and support community health workers. There was also a call for continued support for medical education and residency programs, as well as nursing and nurse recruitment.
There was also unease about potential changes.
“There’s a palpable concern among physicians that another system would not respect independent physicians the way the current administration does,” doctor Michael Papagiko said, referring anti-competitive practices of some health systems.to how some other systems treat independent physician groups as competitors to their own employed practices.
You can find the presentation from Wednesday’s meeting here. NHRMC keeps all public information about the potential sale process here. Those interested can sign up for email updates here.
