Alliances and mergers have become commonplace. Debt consolidation and better purchasing power are pluses of a large parent organization, Sinnott said. That included having physicians occupy one-third of the seats on the board as well as sharing resources and integrating services. But the bottom line is positive, says Sinnott, who also heads St. Agnes and Nazareth, sister hospitals in Philadelphia. There needs to be adequate reimbursement.
Financial solvency is absolutely essential as is the ability to maintain capital investments.
In this fiscally conservative era, though, providers need to make tough choices about under-utilized services. Christiana Care closed Riverside's hospital, although services for extended care, wound care, diabetes, pulmonary rehab and family practice are still available at the campus. Some people were unhappy but the closure did not in any way impair quality of service in the community. To avoid the nightmare of inadequate payments leading to inadequate care, Smith suggested a holistic approach. Managed care and federal budget acts only deal with cost, not how to provide better care for the community.