Volume 56, Number 3 - Summer 2010

 

By Lee Domanico

With Marin General Hospital (MGH) scheduled to return to local control at the end of June, I’m happy to report that the Marin Healthcare District is on schedule with all tasks for the changeover. Following many months of planning and preparation, we expect a smooth transition for physicians, employees and most importantly our patients. Let me touch on some of the key tasks of interest to physicians. 

The District recently selected Union Bank to provide $60 million in financing for MGH. The bank’s proposal includes a $30 million line of credit secured by accounts payable, and an additional $30 million term loan. We received favorable interest rates on both loans, at about 3.25% and 4.25% respectively. 

Over the past several months, we signed new agreements with most of the hospital’s health insurance companies, at reimbursement rates comparable to what MGH currently receives. While there was fear in some circles that MGH would not be able to receive comparable rates as a stand-alone hospital, we found the insurers anxious to work with us to guarantee MGH’s long-term success. To that end, the top six insurers with MGH contracts have agreed to advance MGH 60 days of payments against future services, further strengthening our cash reserves. Those monies will be paid back in one year. 

Designing and then implementing a completely new information technology system for the hospital was one of the largest challenges we faced. For this task, we contracted with ACS, one of the nation’s largest IT providers. I’m happy to report they are on schedule. Training of the “super users,” those who will train others, is already under way, and training for remaining staff will be completed in June.

We continue to meet with MGH employees to answer their questions and provide them with news surrounding the transition. The employees have received these meetings favorably. Another round of meetings is set for June 16. Over the past year, employee turnover at MGH has been extremely low, actually lower than in years past. Only two of the approximately 70 managers at MGH decided to accept jobs with other Sutter facilities, so almost all the administrative team will remain. No physicians have left.

The District Board recently voted to approve a $13 million Physician Development Plan, with up to $4 million to be spent this year for retaining and recruiting local physicians. We are working with several local physician groups to form a nonprofit medical foundation to support physicians who wish to practice under that model. To date the foundation has more than 40 physicians, and we plan to grow that number substantially. 

We have also established a clinic model that offers physicians yet another option for working locally. Recognizing that different physicians will choose to practice under different business models, we aim to provide as much choice as possible. I encourage any physicians with questions or suggestions on recruitment and retention to contact me at the e-mail address listed below.

Recently the District Board approved the bylaws, conflict-of-interest policy and fiduciary responsibility requirements for the Hospital Operating Board, which will oversee day-to-day operations at MGH. A Nominating Committee—composed of two District Board members, two members of the Transition Advisory Committee, and myself—has been interviewing candidates for the Operating Board over the last several months. We hope the District Board will approve a slate of 10 candidates, plus myself, at their June meeting. The Operating Board will be accountable for meeting specific operating metrics and reporting regularly so both the District Board and the community will have the transparency needed to confirm that the hospital is being operated in their best interests. 

All in all, I believe we have come a long way over the past two years to reduce the divisions and uncertainty felt by some of the major stakeholders following the signing of the Settlement and Transfer Agreements in 2006 that put MGH on a course back to local control. We are now all working together to ensure a smooth transition and begin the process of growing MGH into the kind of hospital that our physicians, employees and community expect and deserve. h

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