The Future Of NHRMC: The Six Proposals

Apr 21, 2020

On Tuesday New Hanover County published online the six proposals it received regarding the possible future of New Hanover Regional Medical Center. County Commissioners are slated to decide on one of the proposals, or not, later this year. The proposals range from $1.25 to over $3 billion.

It’s been nine months since New Hanover County Commissioners began the process of exploring the future of the medical center. Sell. Merge. Or remain independent.

Six organizations have made a pitch to New Hanover County. You can read their executive summaries at WHQR.ORG, and explore the full proposals.

They are Atrium Health, Duke Health, along with Bon Secours - Healthspan, HCA Healthcare, Novant Health and UNC Health. All but one are non-profits. 

(Read all the proposals HERE)

Let’s start with Atrium. Atrium’s proposal is a 30 year lease, at which point that healthcare system takes ownership of NHRMC in full.

Chris Coudriet is New Hanover County Manager and a member of the Partnership Advisory Group.

“At least I individually, as a PAG member was not expecting that the majority of the proposals would speak to full integration.”

“Can you say a bit more about what full integration means?”

“More or less an asset acquisition, either through a long-term lease arrangement with Atrium or some of the others where there is an actual exchange of assets at a point in time at closure.”

Next up is Duke Health. Chris Coudriet.

“Duke's proposal is about establishing New Hanover Regional Medical Center as an anchor of a Duke Healthcare System. It's about establishing a fundamental high, not that it's not high quality, but expanding on and making it the second anchor of the Duke Healthcare System.”

“Right. So it becomes part of the Duke Healthcare System?”

“It does, but one of only a couple of hospitals that Duke operates. 

“So do we consider that just an outright purchase?”

“That is an asset acquisition, yes.”

(See all proposals HERE)

All of the proposals emphasized maintaining and expanding the quality of care at NHRMC, and to varying degrees, maintaining local control. All have some flexibility built into their proposals. 

The third is Bon Secours Mercy Health – Healthspan. Healthspan is the non-Catholic arm of Bon Secours. 

NHRMC CEO John Gizdic, and PAG Co-chair Barb Biehner.

“So that was a pretty straightforward acquisition proposal into their non-Catholic division, which is a distinction that raised concerns from at least one onto our website because, if it was a Catholic run hospital, it would limit some of the services that could or would be provided. Healthspan is their non-Catholic division of operating hospitals.”

The first three we have described, are all non-profit medical systems. Five of the six are non-profit.

(Read all the proposals HERE)

HCA Healthcare is a for-profit operator of health care facilities, based in Nashville. It manages more than 200 facilities. It’s also pitching an acquisition. 

PAG Co-chair Spence Broadhurst says HCA, like the others, supports the Strategic Plan.

“I think the majority of the proposals, I think it's fair to say that that majority of the proposals addressed most areas of our strategic plan. Some, some more fully than others, some in some areas, others. But I think they all had great respect for eh and, and, and addressed our strategic plan.   

Novant Health is also in the game. Chris Coudriet and John Gizdic.

“Again, establishing New Hanover as an anchor of the Novant Healthcare System. They were the one that probably flushed out the most options. So the initial proposal is the asset purchase that Chris mentioned. They also fleshed out a joint venture model as well as a management agreement model. So while others – Duke and others mentioned alternative models to their preferred model, Novant did flesh out some of those other models in detail as well.”

Lastly, the UNC Healthcare System. Chris Coudriet and PAG member Dr. Joseph Pino.

“Amplifying an existing partnership. It's a partnership that affords the County, the community to retain full ownership, but partner with the UNC Healthcare System in a way that's more aggressive than what's happening now with the school of medicine. Right. Focused on the academic side of things. So it is purely an academic partnership around potentially expanding the school of medicine and other healthcare related academic programs in the region.”

Again, all the proposals have some flexibility built into their pitches. Nothing is set in stone and commissioners can ask questions and ask for clarifications. 

The proposals range from $1.25 to over $3 billion.

A decision - a recommendation to the County – is expected later this year. 

The next virtual meeting is May 7. Vince Winkel, WHQR News.

THE NUMBERS:

Atrium Health: Long-term lease with most of the hospital board from the local community; more than $1 billion in capital investments in first 10 years.

Novant Health: Multiple proposals with NHRMC serving as regional hub; $2 billion in upfront cash to county; commitment to fund 100% of capital needs over 10 years.

HealthSpan/Bon Secours : $1.3 billion purchase; $400 million in capital investments.

UNC Health: Partnership; propose creating a Wilmington campus of the UNC School of Medicine; give hospital two spots on UNC board.

HCA HealthCare: Multiple options proposed, including possible purchase for $1.25 billion.

Duke Health: Develop a strategic partnership with NHRMC; retain all employees for 12 months; $500 million to form community foundation.