Providence and Hoag Split, Ending Decade-long Affiliation

Hoag's independence will drive the expansion of reproductive health services in Orange County.

In a joint statement released on Monday, Providence and Hoag officials announced the two organizations have agreed to "amicably" end their nearly 10-year affiliation.

Hoag will become independent from Providence and Covenant Health Network (CHN), the vehicle for the organization's affiliation with Providence to promote population health initiatives in Orange County. Hoag's independence will drive the expansion of reproductive care in Orange County.

The split comes 20 months after the founders of Hoag Memorial Hospital Presbyterian filed a lawsuit to dissolve CHN and end the affiliation.

"We appreciate the relationships we built over the last several years with the Providence and St. Joseph teams. This move opens up new avenues of collaboration in the future, as each institution brings its unique strengths to bear in service of patient health," Robert T. Braithwaite, CEO and president of Hoag Memorial Hospital Presbyterian, said in the joint statement.

Additionally, Providence president of operations, Erik Wexler said: "Although we are formally parting ways, we will have other opportunities to work together on behalf of the community. We look forward to future collaborations with our colleagues at Hoag, whom we continue to hold in high regard."

HealthLeaders was told that neither Providence nor Hoag will be providing any further statements.

California AG reaction

California Attorney General Rob Bonta agreed not to object to the disaffiliation on Monday, citing that the settlement will allow Hoag "to become an independent entity," which will lead to the expansion of reproductive health services in Orange County.

In a separate press release, Attorney General Bonta said "In a time when reproductive rights are under attack, we have to take every reasonable step we can to protect and expand reproductive healthcare in California. The separation of Hoag from Providence will allow two strong health systems to continue to operate, while allowing Hoag to expand access to essential reproductive care in the area."

Hoag's expansion of reproductive healthcare for Orange County will include:

• Pregnancy termination services in Hoag Hospital-owned facilities
• The creation of a formal program to address family planning, contraception, and the management of high-risk pregnancies
• The recruitment of family planning, contraception, and abortion experts to provide a full range of expert family planning services
• The recruitment of primary care and medical specialists to provide the LGBTQ+ community with sex-specific and gender-specific healthcare

It was noted in the press release that while the Attorney General's office was "not a party to the settlement," the finalization of the settlement was "contingent on any objections from the California Department of Justice."

Past disappointments come to an end

In November 2020, Wexler told Healthleaders that Providence was "disappointed" in Hoag's lawsuit and effort to dissolve the affiliation.

"Hoag is an outstanding institution and has been part of superb population health growth strategies in Orange County, along with Providence St. Joseph Health, for almost a decade," he said. "In these changing and difficult times, and with an imperative to advance healthcare, staying together is, from our point of view, a lot better for our community than potentially separating and having cannibalization and duplication of services."

"It's disappointing," Wexler added. "It just seems mostly like a desire of Hoag to simply just have independence."

During an interview in December 2020, Braithwaite told HealthLeaders that Hoag's initial relationship with St. Joseph Health was "based on the premise that we would bring together the two organizations and that we would basically serve Orange County through a population health strategy. The first couple of years were challenging, but nonetheless, everyone was very committed to working through those challenges, and serving Orange County."

But following the 2016 merger between St. Joseph and Providence Health, Hoag felt it wasn't achieving their vision.

"We were trying to focus on Orange County. That was who we serve and who we were serving with St. Joseph's. [Providence has] more of a western states, national-type vision and orientation,” he said. "What we clearly saw was a lot more decision making started moving farther and farther away from Orange County, and so our challenges grew in many ways."

Now that the affiliation has been formally disbanded, both organizations said they will continue to remain committed to "meeting the health needs of Southern California."