Partnerships: Does One Size Fit All?

Carrie Vaughan, for HealthLeaders Media, May 14, 2008

I am hearing more and more about hospitals working together to provide better care to their communities. Whether it's through joint ventures like radiation oncology centers or dialysis centers, sharing a limited pool of specialists through visiting physician programs, or pooling resources for a consultant, such collaborations offer numerous benefits. Hospital partnerships can reduce duplication of services, allow facilities to share physicians who are in short supply, or simply save money. Unfortunately, these types of relationships present plenty of headaches, as well--not the least of which is finding the right partner and ensuring that the arrangement benefits both parties.

I wrote about some of the ways hospitals are collaborating with each other in HealthLeaders magazine's May cover story, "Shared Success." While reporting on that piece, I began wondering: Is it more beneficial to partner with multiple organizations in a best-of-breed approach, or does a one-size-fits-all strategy work best?

For example, Emanuel Medical Center in Turlock, CA, has partnered with Stanford (CA) Hospital & Clinics in a radiation oncology center and with Children's Hospital Central California for pediatric hospitalists. Michael Iltis, Emanuel's vice president of professional services, says that his hospital will continue to partner with centers of excellence that can help them provide high quality care rather than trying to establish those programs themselves.

Sanford Health, in Sioux Falls, SD, and Orange City (IA) Area Health System, meanwhile, have a more comprehensive affiliation. Under the management agreement, Orange City's chief executive officer is a Sanford employee who is contracted to Orange City, which has access to greater purchasing power and expertise in compliance issues as a result of the partnership. Sanford is also helping Orange City link to its technology platform and implement an electronic medical record. The two hospitals also joined forces to open a dialysis center in Hospers, IA.

In Nashville, Saint Thomas Health Services has partnered with various independent community hospitals across the region through its Saint Thomas Chest Pain Network. Wes Littrell, the system's chief strategy officer and president of STHS Affiliates, says that they use simple affiliation agreements with the members of the chest pain network. "Usually, we try to move with the first right of refusal. Something with them that says, ‘If you are going to look for that service, ask us first. If we can provide it for you, we will. If we can't, then you can go somewhere else to get it.'"

For a smaller hospital, I wonder if it makes more sense to partner with various hospitals throughout the region that excel in one or two services, or build a more comprehensive relationship with one hospital. In the technology realm, many facilities began second guessing their best-of-breed approach in favor of one integrated clinical, administrative, and financial package, which saved some hospitals $1 million.

So should smaller facilities find one hospital and build a true relationship? Or is it better not to put all your eggs in one basket? Send me an e-mail to let me know your thoughts.

Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at

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