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Joining forces for health care efficiency

BMH, Grace Cottage, and Dartmouth-Hitchcock to conduct joint study to find ways to maximize access while controlling costs

BRATTLEBORO—Windham County’s two hospitals are joining forces with Dartmouth-Hitchcock Medical Center (DHMC) to find ways to deliver health care more efficiently and save money in the process.

Brattleboro Memorial Hospital, Grace Cottage Hospital in Townshend, and Dartmouth-Hitchcock in Lebanon, N.H. will be working with Helms & Company, a Concord, N.H. health care management firm.

BMH President and CEO Steve Gordon and Grace Cottage interim CEO Meg Cleary said last week that, over the next few months, Helms will conduct interviews and assessments and look at utilization and referral data over the next few months at both hospitals.

Doctors, patients, administrators and staff will all be asked to take part. Gor­don said the study should be finished by October and presented to the board of directors at both hospitals.

“This is a very board-driven process,” said Gordon, “so there’s a higher probability of success. No one is coming in with preconceived notions.”

Gordon said the collaboration between the two hospitals and DHMC is a natural one. “The service mix between our hospital and Grace Cottage is complementary. “It makes these discussions easier, since we’re starting out further along than most hospitals in sharing resources.”

“This is the next logical step for us,” said Cleary. “And, with all the changes ahead for health care, we’re trying to figure out how to increase access to most of our community and reduce costs.”

Grace Cottage, the smallest hospital in Vermont, has 19 beds and concentrates on acute and rehabilitative care. It also has a fully-staffed 24-hour emergency department.

BMH is bigger, with 61 beds, and focuses on primary and specialty services. However, like Grace Cottage, it uses DHMC as the next level of care provider for emergency cases and more complicated acute conditions.

Both Grace Cottage and BMH already share specialists and, along with DHMC, are also current participants in the OneCare Vermont Accountable Care Organization (ACO), which is working to develop new payment models for Medicare patients in the Green Mountain state.

Gordon said that there is not a lot of duplication of services between BMH and Grace Cottage, but the goal is to keep what unique about the two hospitals while sharing clinical services.

“We trying to identify our needs, and respond to them,” he said.

Cleary, who is also a principal with Helms & Company, said staffing levels at the two hospitals are still to be determined, but the study will likely inform where they go next.

Even her own job at Grace Cottage will be shaped by the study. Cleary said the hospital wanted to do a top-to-bottom assessment before hiring a full time CEO, and it used this opportunity to approach BMH about doing a joint review.

The good news, Gordon said, is that both hospitals are is sound financial shape, so it makes it easier to look at ways to save money without compromising the quality of care.

“So much of health care right now is driven on the outpatient side,” said Gordon. “And Windham County has the fastest aging population in the country. We’re trying to stay ahead of that curve.”

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Originally published in The Commons issue #202 (Wednesday, May 8, 2013).

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