Yale and L+M affiliation a success story

As the affiliation of L+M Healthcare with the Yale New Haven Health network prepares to enter a fourth calendar year, the evidence is convincing that the association has been to the good.

Since the affiliation began in 2016, L+M Healthcare has moved from a situation in which it was facing persistent operating deficits, to a break-even budget in fiscal year 2017, to experiencing a 3.5 percent positive margin — about $15 million — for the fiscal year that ended Sept. 30.

In addition to Lawrence + Memorial Hospital in New London, L+M Healthcare includes Westerly Hospital and the Visiting Nurse Association of Southeastern Connecticut and other ambulatory services throughout the region.

New London treasured its independent community hospital, but the world of providing health care — and the pressures placed on the system to provide it more affordably — has changed. If anything, affiliation should have come sooner.

The Yale New Haven Health network provides economies of scale that were not available to L+M as a small, independent operation. The Yale brand has proved an aid in recruiting top personnel. Medical services that once required traveling outside our area are now available locally.

L+M remains home to the area’s only Neonatal Intensive Care Unit, a carryover from L+M’s time as an independent hospital. It is now also the only hospital in eastern Connecticut to perform emergency and elective angioplasty — a procedure in which surgeons use a balloon-tipped catheter to enlarge a narrowing in a coronary artery, restoring healthy blood flow.

L+M Healthcare’s vitals are good, with the patient census up 5.6 percent over the prior year. In 2018 L+M Healthcare added two surgeons and 22 primary care providers — doctors, physician assistants and advanced practice registered nurses.

And there is labor peace, with union contracts set to expire in 2019 renegotiated a year early and extended to 2022.

The providing of health care is more competitive than ever, with much of our state divided among large health care networks. On the week the editorial board sat down with Patrick Green, president and CEO of L+M Healthcare, Hartford HealthCare had announced its intentions to build a $20 million health center in Mystic. Hartford HealthCare also operates The William W. Backus Hospital in Norwich.

Green has directed L+M since shortly after its affiliation. He said the reality of competition will continue to drive performance and growth. Peppering his talk with references to “superior patient experience” and “learning from our patients,” Green said L+M can’t afford to lose sight that people have choices.

“We look at the patient experience every single week, line by line,” Green said of patient surveys.

The uncertainty of a patchwork system that creates large gaps in how the nation assures access to health care — or more accurately fails to assure it — poses the greatest challenge to our medical facilities. Efforts by the state and federal governments to tighten Medicare and Medicaid reimbursements will continue to strain margins. L+M reports that in FY 2017, the gap between what services cost and what Medicaid reimbursed amounted to a $24.8 million loss.

In addressing one of our concerns, that these large hospital affiliations enjoy property tax exempt status as nonprofits, while benefiting from city services borne by taxpayers, Green pointed to the “in-kind contributions” that L+M provides New London and surrounding communities, including care for the indigent. In 2017, L+M reported providing free or discounted health care services to 3,534 eligible patients at a loss of $16 million.

It is a fair argument, yet one that does not help New London or its overtaxed property owners. The state must find a way of compensating cities that host regional service providers, such as L+M, without the benefit of assessing property taxes on them.

That is a separate issue, however, from the good news that L+M Healthcare stands stronger than it did a few years ago when the affiliation with Yale New Haven was first entertained.

 

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Editorial Page Editor Paul Choiniere, retired Day editor Lisa McGinley, Managing Editor Tim Cotter and Staff Writer Julia Bergman. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.

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