WILMINGTON — Last week the PAG narrowed six proposals to partner with or purchase New Hanover Regional Medical Center down to three, leaving aside an offer from UNC Health. Some have asked whether the move will have a lasting impact on the relationship between the UNC School of Medicine and the region, including UNCW and NHRMC.
Those concerns stem from the language in UNC Health’s proposal which indicates if the Partnership Advisory Group (PAG) — and ultimately the county commissioners — choose a different proposal, then UNC will either scale back or end its current School of Medicine program in the Wilmington area.
It’s worth noting that on Thursday, the PAG voted to focus on three of the six proposals; while the PAG will be looking more closely at offers from Novant, Atrium, and Duke, the remaining three proposals from non-profits Healthspan/Bon Secours Mercy and UNC Health, as well as for-profit HCA, will not yet be eliminated, “pending additional public input and further evaluation,” according to NHRMC.
Still, some — including the Save Our Hospital organization and New Hanover County Commissioner Rob Zapple — have voiced concerns that UNC Health’s proposal will not have a comeback based on public input or other considerations. That, they fear, will lead to a negative impact on the relationship — or the end of the relationship — between UNC School of Medicine and both NHRMC and UNCW.
As both SOH and Zapple have opposed the sale (or at least what they perceive as the ‘haste’ in which the process is being conducted), they were likely encouraged by language in UNC Health’s proposal, which specifically discouraged a sale or partnership that would hand over control or equity to an outside company.
“NHRMC is strong and capable of meeting the near-term challenges that face all health care organizations. Therefore, we believe the best current course of action is for NHRMC to remain independent and not pursue a sale, extensive management services agreement, or any other significant equity partnership that may require other terms or commitments that are less desirable right now,” UNC Health wrote in its full March 16 proposal.
Expanded partnership or nothing?
Unlike several other proposals for NHRMC, UNC Health’s proposal did not include a billion (or multi-billion) dollar offer. It did put forward an “academic and expanded clinical partnership along with capital investment” with NHRMC.
“At a high level, our proposed academic partnership includes the creation of a local enterprise that will recruit, train, and develop the health profession workforce needed to serve southeastern North Carolina and extend the clinical research infrastructure and capabilities of UNC Chapel Hill and the UNC SOM to NHRMC,” according to UNC Health’s proposal.
Key proponents would include:
- Rapid and substantial growth of the Wilmington SOM branch campus
- Expansion of residency and training programs
- Expansion of the UNC SOM Wilmington branch campus to include other health profession schools
- Program partnerships with University of North Carolina Wilmington (UNCW)
- Furthering NHRMC’s clinical research capabilities and access to grant funding to provide the nearly 500,000 residents of southeastern North Carolina access to the cutting edge research at UNC SOM.
But, by the same token, UNC Health indicated that if its proposal wasn’t chosen, not only would it not pursue this expanded relationship but “UNC Health and UNC School of Medicine will not be able to continue our current educational and clinical presence in Wilmington.”
The proposal doesn’t precisely indicate whether that would be a reduction or a complete closure — but it does gesture at both, including a reference to closing the School of Medicine satellite campus in Charlotte. Talks between UNC Health and Atrium stalled in 2018 and the healthcare system partnered with Wake Forest instead to bring a school to Charlotte.
“If you choose to embark with another partner, it is likely that our education and clinical presence would significantly diminish. The reality is that new health system partnerships sometimes compromise existing educational partnerships. That was demonstrated with the upcoming closure of the UNC SOM branch campus in Charlotte,” according to the proposal.
The PAG followed up with questions for UNC Health after receiving this initial proposal, asking UNC Health to clarify its response. The PAG asked UNC Health to confirm that “the proposed Academic Partnership is something that UNC could or would consider in connection with any County/NHRMC partnership with a health system that isn’t within an academic model.”
However, UNC Health had essentially already stated the opposite and, in its response on April 10, repeated its statement almost verbatim, again saying that if the PAG passed on UNC Health’s proposal it would diminish — and possibly remove — its presence in the Wilmington area.
Wait and see?
According to UNC Health spokesperson Alan Wolf, the organization is ‘disappointed.”
“UNC Health had proposed a strategic partnership with New Hanover Regional Medical Center that would have included expanding our clinical and medical education relationships. While we are disappointed not to be included among the final three candidates, we are grateful to be considered,” Wolf said in a statement from UNC Health.
Wolf did add that nothing would be decided about the future of the School of Medicine’s future in Wilmington until New Hanover County Commissioners made a final decision.
“UNC Health is an experienced and trusted partner to healthcare organizations and educational partners statewide. We will wait to see what the County Commissioners ultimately decide before commenting on future opportunities in medical education in the Wilmington region,” Wolf said.
Send comments and tips to Benjamin Schachtman at firstname.lastname@example.org, @pcdben on Twitter, and (910) 538-2001