Particularly if locations are not too geographically dispersed, opportunities may exist for systemwide service line management. This may make significantly enhanced clinical management expertise available to smaller facilities within the system.
Where system facilities are geographically dispersed, opportunities may exist for expanded use of telehealth (often from the system’s flagship academic medical center, its largest regional referral center or under contract from another academic medical center):
Table 3 – Beginning List of Potential Telehealth Opportunities
Remote ICU
Radiology
Cardiac monitoring
Primary care
Follow-up care
Off-site pediatric care
Behavioral health
Given multiple facilities, advantages may be gained via internal development of systemwide clinical staffing pools and/or contracts for:
Table 4 – Potential Staffing Pools or Contracts
Nurses
Therapists
Emergency physicians
Radiologists
Radiation Oncologists
Anesthesiologists
Pathologists
Flexibility provided through the larger system may promote strategic location of microhospitals (including 24/7 emergency services, a limited number of inpatient beds and diagnostic services) , perhaps replacing older and limited service facilities but augmented with additional telehealth capabilities.
Some opportunities will be primarily available to systems including an academic medical center with significant bench-to-bedside research emphasis. On the cutting edge are possibilities such as:
Table 5 – Sample Sophisticated Clinical Services Expansion
-Reserved intra-system transfer beds
-Cancer care research protocols
-New neuroscience procedures and treatments
-Centralization of high cost services such as proton therapy
-Use of AI to evaluate surgeons’ performance
Not all of these opportunities will be best in every merger. But these are just the beginning of potential merger opportunities. Which have your system adopted? Which ones have not yet been considered? Have you really taken advantage of your potential post-merger opportunities?
Mr. King is long-time SC HFMA member; prior Oregon Chapter President; Chapter Member in OR, Southern California, San Diego/Imperial, Louisiana, North Carolina Chapters; past HFMA National Matrix and Committee member, and; Region Eleven Chapter Liaison Representative. He holds the HFMA’s Fullmer, Reeves, Muncie and Award of Honor individual awards, and has served as CFO on permanent and interim bases for independent community hospitals, a multistate hospital system, and a large academic medical center, in OR, CA, KY, MO, IL, MN and DC. Brad is also a former Principal for CliftonLarsonAllen, based in the Charlotte office. He currently serves as an interim CFO and independent consultant on hospital mergers and acquisitions. Brad and his wife, Susan, live in Tega Cay, just north of Rock Hill, SC.
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