Last week, UAMS released some 75 pages from the Deloitte Consulting report that it and St. Vincent Infirmary commissioned on ways to affiliate. The rest has now been released. It focuses on the affiliation of cancer and cardiology services.
Deloitte opines that the scale of an affiliated “comprehensive cancer center” would have the scale to “remain viable through impending healthcare changes,” and notes that UAMS and St. Vincent will have competition from an expected CARTI cancer center. It notes that UAMS’ has enough capacity in its MRI scanners that could “offset” St. Vincent’s planned investments in MRI equipment, which sounds to me like the equipment at a state facility will subsidize the private St. Vincent. That is strictly from a layman’s reading of the report; would be happy to be corrected if that’s not right.
The report also looks at the savings in operating expenses that affiliated cardiovascular units could expect. It notes that neither UAMS nor St. Vincent are fully using their heart catheterization labs but fall between 40 percent and 60 percent utilization, and that St. Vincent could handle all the heart cath procedures.
Risks: Remember the question posed last Friday about physician pay? Deloitte says physician income needs to be realigned to “ensure consistency and appropriateness.” Deloitte also warns that “market share may be at risk if reform, rate pressures or other factors increase early retirements,” a factor at St. Vincent since 63 percent of its cardiologists are over 55. Moving UAMS to St. Vincent could mitigate that problem.
Deloitte argues in favor of affiliation because of health care reforms toward bundling of services, medical homes and coordination of care. Patient data (HIE) would be more easily shared.
The report does not address integration of other clinical care besides cardiac, cancer and primary. It does not address the issue of reproductive health care that affiliation with a Catholic organization represents.
The second part of the report is heavily redacted. UAMS has rejected the Arkansas Times’ argument that there should be no redactions, since public dollars paid for half the report. Lawyer activist Joann Coleman has also argued that the redactions violate the state Freedom of Information Act, writing UA lawyer Fred Harrison that St. Vincent is “currently intertwined in ‘public business’ with the state and that Deloitte itself, by contracting with a state agency, was obligated to release an unredacted report.