This week, UNC Health announced it had plans to build a new community hospital in Wilmington.
The state-owned health care system, which is affiliated with the UNC School of Medicine, said it aims to expand access to both speciality and primary care with a hospital located at South 17th Street and Shipyard Boulevard. The 62-acre site, located just a mile from Novant NHRMC, will be home to a hospital complex offering emergency care, cardiology, oncology, obstetrics, and other services.
The proposal has the support of Wilmington Health, and its “providers are expected to participate on the medical staff of the new facility,” according to UNC Health.
The hospital will require the green light from the state, through its Certificate of Need (CON) process, which gives the North Carolina Department of Health and Human Services (DHHS) the power to regulate new services, hospital beds, or major equipment based on its assessment of the need.
WHQR asked Bovio, now UNC-Health’s regional president of its southeastern coastal market, for his thoughts on the proposal, what it might mean for the healthcare market in the greater Wilmington area, and the process and prospects of getting DHHS approval.
Why Wilmington and why now?
For a long time, New Hanover Regional Medical Center — first as a county-owned hospital and then under Novant Health’s ownership — has been the only hospital in Wilmington, and the primary facility in the region (although there are other hospitals in region, including Dosher, Brunswick Medical Center, and the Columbus Regional Healthcare System).
Bovio said the population growth was a primary driver for UNC Health’s decision.
“I mean, the surrounding seven or eight counties will be approaching a million residents over the next five to seven years, and the demand for healthcare services is continuing to outpace the availability of those services,” Bovio said, noting that DHHS’s most recent State Medical Facilities Plan highlights a need for 225 beds in New Hanover County in the next couple of years.
Bovio also said he had a “pretty unique perspective” after working in the region for the past few years, and that he’d heard increasing demand for alternatives to the existing healthcare options.
“I think after listening to the residents in the community, it's clear they want more health care, more access to primary care and specialty care, and they want an alternative and a choice, and without having to travel out of town for that alternative,” he said. “It's very clear to me that there needs to be choice.”
Healthy competition?
It’s no secret that there is a fair amount of public frustration with the quality of care at Novant NHRMC. The hospital has received middling overall ratings from Leapfrog, a non-profit watchdog for hospital safety, and the Centers for Medicare & Medicaid Services, part of the federal health department that issues hospital quality ratings. In past years, some of the particular metrics behind those ratings, including the death rate for surgical inpatients with serious but treatable conditions and composite safety scores, have prompted public concern.
[Editor’s note: WHQR spoke with NHRMC leadership about its latest ratings and ongoing efforts to improve quality on Thursday, and will have reporting on it later this week.]
So what will it mean for the area to have another, if smaller, hospital?
Bovio said he’s been getting the same question a lot: whether UNC Health would complement Novant’s services, or offer some healthy competition.
“Wouldn't it be great for our community if there were multiple healthcare systems making significant investments to build more capacity and to build out more healthcare infrastructure, to recruit more docs and provide more services? I think the answer is yes, and it's going to take more than one healthcare system to keep up with the growth,” he said.
Bovio said there was more than enough need to go around, and that his experience in Wake County and in Texas was that having competing healthcare systems was ultimately good for the public.
“I've worked in some very competitive markets. I was with UNC Health in Wake County, where you had three very high-performing healthcare organizations competing with each other, and it certainly made everyone's service level, and quality — everything was better, because it had to be. So, yeah, I think it’s going to be some healthy competition, and it’s needed.”
NHRMC President Laurie Whalin acknowledged that the public generally feels that competition is a good thing, but said the proposed UNC Health hospital wasn’t necessarily comparable to NHRMC.
“What I think is needed is access, and I think Novant is delivering on our plans to deliver that to the community, and making sure that we do have the high-quality physicians, the specialists, and the facilities to take care of that,” she said. “I think having a 100-bed hospital down the road probably is not going to provide that impact [...] we are the tertiary, quaternary care center, and we always will be, so the level of services will never be comparable. So to me, it's just not even comparable from that standpoint.”
Relationship with Novant
While Bovio could be seen as returning to southeastern North Carolina as a competitor with his former employee, he had nothing but good things to say about Novant or his time overseeing NHRMC.
“I'm very proud of the past two years and the time that I spent at Novant. And to see what that team has accomplished during that time, the improvements that have been made [...] I’m very confident in the plan that Novant Health has. They're executing the plan. They're making improvements. All the key performance indicators are heading in the right direction, strong leadership team, strong position leaders, and they're going to be in a much better place,” Bovio said, adding that he believed Leapfrog and CMS ratings, which are based on metrics that can lag up to four years behind, would soon start showing those improvements.
He also noted that the proposed hospital won’t impact UNC Health’s affiliation with Novant through the pediatric program, which recruits pediatric specialists to the area, and the UNC School of Medicine branch in Wilmington, which utilizes NHRMC as a teaching facility. The two healthcare systems also work together on bringing more clinical trials to the Cape Fear area.
Certificate of Need timeline
Bovio said that the application for the CON process is due June 15, acknowledging that the date is “coming up pretty quick.”
“We're developing the application now. We're soliciting community support and physician support,” he said.
After filing the application, there’s a public comment period expected to run through the end of July, which is also an opportunity for competing applicants to “comment on each other’s applications and kind of poke holes and challenge each other's applications,” Bovio said.
After that, there will be a public hearing in August, to be held somewhere in New Hanover County. After that, the state is expected to make a decision by the end of November.
“So by the end of the year, we will know who the state is awarding beds to,” he said.
Bovio said he didn’t expect there to be any pushback from the state itself, based on the need.
He noted that, in his opinion, “if CON didn't exist, there would already be another health care system in Wilmington, and so I'm glad there's these beds available so that we can get started on it. It's sort of, to me, an inflection point, and now we need to really take advantage of this opportunity as a community to bring another healthcare system here.”
Pending approval, UNC Health is aiming to open the hospital in 2030.