SOUTHEASTERN, N.C. — As the Partnership Advisory Group inches closer to narrowing down its top pick for New Hanover Regional Medical Center’s (NHRMC) new partner or owner, the groups vying for the role have turned up the heat.
Earlier this month, Atrium Health shared a $2 billion asset purchase option, nearly doubling its first offer and matching Novant Health’s initial $2 billion cash offer — the largest assessment to date.
The same day, Duke Health emphasized that its previously pledged $1.9 billion 12-year capital commitment to NHRMC “represents the minimum level of investment.” Still, Duke Health acknowledged it isn’t the highest bidder. It did appear to share a couple of digs at its competitors, stating its attention to NHRMC was selective and focused, “not.. just another acquisition target” or “repeated commodity simply to get bigger.”
Late May, Novant Health announced it had partnered with UNC Health shortly after community leaders raised concerns the area’s relationship with the university had already soured. The Partnership Advisory Group (PAG), tasked with making a recommendation to New Hanover County Commissioners, ruled UNC Health out of its top three picks for potential partners: Novant Health, Duke Health, and Atrium Health.
Unlike the other options presented, UNC Health was the only proposal out of six that would not name a dollar figure for its proposed acquisition or overall capital investments, though it did pledge $375 million to support academic operations over a 20-year period. Pressed for details from the PAG, UNC Health again re-emphasized something of a threat: choose another partner and we’ll likely pull out of the region.
UNC Health and NHRMC currently enjoy an academic training partnership, with third and fourth year UNC medical students completing clerkships locally. The partnership serves as a qualified pipeline for the region, providing southeastern, N.C. with skilled medical professionals who are more likely to stay or return after completing their training at the branch NHRMC campus.
UNC Health brought up the recent closure of its School of Medicine branch campus in Charlotte, where talks with UNC Health and Atrium stalled in 2018 when Atrium chose to instead partner with Wake Forest. “The reality is that new health system partnerships sometimes compromise existing educational partnerships,” UNC Health’s proposal states.
Seemingly responding to the Novant-UNC partnership, Atrium positioned itself as more independent and able to act on its academic promises, citing its own recent partnership with Wake Forest Baptist Health. Because UNC Health is partially funded by the state, Atrium seems to suggest the public institution would be stuck dealing with red tape.
“Moreover, with a private academic medical partner and the ability to build and fund medical education and research efforts without the prior approval of political bodies, Atrium Health can unequivocally deliver on its commitment to medical education and research,” Atrium’s June 17 asset purchase offer states.
Duke Health also seemed to address the UNC-Novant partnership in its additional comments earlier this month. Partnering with Duke Health would mean NHRMC could engage in an accelerated timeline with lower risks, its comments assert: “We eliminate any potential uncertainty resulting from reliance on third parties and involvement of state-controlled organizations.”
Before Novant Health announced its partnership with UNC Health May 21, it referenced its partnership with Wake Forest when asked by the PAG how Novant would uphold or alter NHRMC’s existing academic partnership with UNC Health. Novant cited its long-standing partnership with Wake Forest to train residents and fellows at and fellows at Novant Health Forsyth Medical Center in Winston-Salem.
Monday, Novant Health’s spokesperson said its relationship with Wake Forest would not be impacted if selected by New Hanover County Commissioners, including its new UNC Health partnership.
New details from Novant
When it first announced its partnership with UNC Health, Novant Health shared limited details with the public about what the arrangement would entail. But last week, it did, sharing three major points:
- “Expand Wilmington branch campus of the UNC School of Medicine from 18 to 30 students by 2026; enhance faculty development, expand rural pipeline for students wishing to work in rural North Carolina; establish a new UNC Health Sciences campus based out of South Eastern Area Health Education Center (SEAHEC).
- “Develop a children’s clinical service-line partnership with UNC Children’s at Novant Health-affiliated sites in New Hanover and adjacent counties; create outreach clinics and provide telehealth services from Chapel Hill; provide access to complex care services.
- “Develop research, clinical trials and population health studies programs. Develop academic efforts on community health challenges, such as opioid addiction, social determinants of health and health equity.”
Dr. Pam Oliver, executive vice president at Novant Health and president of Novant Health Physician Network, explained the main driver behind the partnership was witnessing the community’s anxiety over losing UNC Health’s presence at NHRMC.
“We feel that our initial proposal, our flexibility, our culture, there was so much that we thought made us a strong contender on our own,” Oliver said, adding that however, Novant Health realized the importance of not disrupting the NHRMC-UNC partnership. “We very much heard from some of the community that there’s a concern about losing that partnership.”
“If you think about the other two finalists, Duke would not be amenable to having a UNC medical education program in their facility. Atrium has partnered with Wake Forest as their partner for medical education. There was very little assurance or even consideration that UNC would remain — they could potentially do something but not with UNC.
So yes, I would say to salvage the relationship specifically with UNC I would say is a big part of this,” Oliver said Friday.
It’s clear how the partnership would place Novant Health in an even more competitive position as the PAG gets closer to making a non-binding recommendation, expected in July. But what’s in it for UNC Health?
“To lose an entire branch campus would completely disrupt their ability to continue to train the same number of students or would require them to think about an alternative location for those students. They benefit by being able to maintain the level of student education that they have. And with us, we don’t want to just maintain it, we want to continue to grow it,” Oliver said.
Compared to other systems that can bring an academic partnership, Oliver said she feels overall, the mission of UNC and Novant are more aligned with New Hanover County’s desired commitment to community care.
Novant Health has already benefitted from the NHRMC-UNC Health program, Oliver said, employing several physicians on staff at Novant Health Brunswick Medical Center who trained through it. Part of the UNC-Novant partnership also means incentivizing medical students and residents to work and stay in rural areas.
Keeping the NHRMC-UNC partnership intact — and investing to expand it — means talent can continue to arrive at the area’s medical centers.
“We see New Hanover as our flagship, as the hub, not as an extension of Charlotte, not an extension of any other area, but a standalone flagship that then Brunswick is a part of,” Oliver said. This strategic plan does not including raising costs — “that is in no way our plan, our intent, or what we would let happen in that community,” she said.
With the highest cash offer and overall investment value offered, at $5.3 billion overall, Oliver said the system’s commitment to the community makes it stand out from the remaining proposals. Novant Health pledges free charity care to uninsured patients up to 300% of the federal poverty level. In recent presentations, Oliver said the system’s commitment to affordability and equity continues to impress stakeholders.
“Our commitment to health equity is unmatched,” she said.
Whether they are selected for purchase or partnership, Oliver said all options are still on the table, letting the community lead the conversation. “We obviously do believe that being wholly part of Novant Health brings the most value overall but we do feel very comfortable with alternative partnerships where it’s not an all in.”
PAG meets Thursday
View all six proposals and supporting documentation.
The PAG will meet again Thursday, July 2, from 5:30 to 7:30 p.m. This meeting was originally planned to take place at UNCW on the 7th but has since been rescheduled.
The meeting will be held at the New Hanover County Government Center in the Andre Mallette Training Room. Limited attendance is available due to Covid-19 restrictions. The meeting will be live-streamed on NHCTV.com.
Share thoughts and opinions with PAG members at PAGcomments@nhcgov.com.
Send tips and comments to Johanna Ferebee Still at johanna@localvoicemedia.com
