Signed and sealed, hospital is now an MGH subsidiary

By Nelson Sigelman - March 8, 2007

It is official. On March 1, Martha's Vineyard Hospital officially became an affiliate of the Massachusetts General Hospital and a member of Partners HealthCare.

The board of trustees of Martha's Vineyard Hospital and Massachusetts General Hospital (MGH) formalized an agreement, the details of which were first revealed last October, on March 1. Nantucket Cottage Hospital did the same.

In prepared remarks, Peter L. Slavin, MD, president of the Massachusetts General Hospital, said that the MGH looks forward to working closely with Martha's Vineyard Hospital to build on the relationships that have existed between the institutions for many years. "Ensuring that the full spectrum of high-quality health care services is available to patients and families who live on or visit the islands has been and remains our number one focus," Mr. Slavin said. "We are very pleased to be able to work much more closely with the outstanding staff at Martha's Vineyard Hospital to enhance or add those services that will be helpful to the island community."

As affiliates of Mass General, the two island hospitals now join Partners HealthCare System, a nonprofit founded in 1994 by MGH and Brigham and Women's Hospital, both in Boston, that includes Newton-Wellesley Hospital, North Shore Medical Center, Faulkner Hospital, McLean Hospital, and Spaulding Rehabilitation Hospital.

The hospital has explained the new corporate relationship between Martha's Vineyard Hospital and Partners this way: "In this affiliation..., although Mass General is not buying MV Hospital in the formal sense, Mass General will become the sole member of the Martha's Vineyard Hospital Corporation. As the sole member, Mass General will have the authority to review and approve any significant transactions or major decisions, have the final word in the hiring and firing of the Chief Executive Officer, and would be responsible for approving each year's annual operating and capital budget. The Martha's Vineyard Hospital Board of Trustees will retain its authority over all MV Hospital corporate decisions, continue to be responsible for ensuring the delivery of high-quality health care, and maintain its oversight of MV Hospital operations, management and finances."

Tim Walsh, Martha's Vineyard Hospital chief executive officer, said that in some ways the actual passing of the documents that made the change officials was anticlimactic, given all of the attention that preceded it. But that did not diminish his optimism about what he thinks the change in ownership will mean for the Vineyard. "We are really excited about it," he said. "It is just a great moment for the future of health care on Martha's Vineyard."

Mr. Walsh said that becoming part of MGH would enable the hospital to tap new resources and take advantage of programs and systems not readily available to smaller medical facilities. As an example, he cited the medical information systems and technology Partners has developed over the past 10 to 15 years. "Everybody is trying to do that, but when you are 25 beds you do not have the infrastructure to afford that," he said.

Mr. Walsh said that over the next several years his focus will be on improving the Island's medical records system and saving money. He said he expects to take advantage of Partners' group purchasing and self-insurance plans.

Mr. Walsh said he also wants to work with the Island's physicians to evaluate what medical services are needed, particularly in specialty areas, and to fill those gaps. "We now have a partner to sit down with and work on those areas," he said.

The hospital board next meets on March 24. Under the agreement, Partners appoints 20 percent of the hospital board.

Joining the board of trustees is MGH president Dr. Peter L. Slavin; Ann L. Prestipino, MGH senior vice president for surgical and anesthesia services and clinical development; Dr. Andrew Warshaw, MGH chief of surgery; and Brent L. Henry, vice president and general counsel of Partners HealthCare System.

Dr. Warshaw, a Chilmark seasonal resident, is chairman of the MGH Department of surgery and a MGH hospital board trustee. In a telephone call Tuesday from his Boston office, Dr. Warshaw said the affiliation will build on and formalize existing professional and personal relationships that have existed for some time between Mass General and Martha's Vineyard Hospital.

"There are an awful lot of us, not just me, who have a great interest in the Island," said Dr. Warshaw, "so we can see first-hand that having superior care available for people who are on the Island, either year-round or part-time is of great importance."

Aside from the increasing familiarity that can be expected to develop as physicians on both ends get to know each other, there are the benefits associated with electronic medical record keeping, said Dr. Warshaw. "It is clear to me," he said, "that being able to access information, to access test results, to access the notes of perhaps a specialist that has seen the patient in a timely fashion will help the physicians on the Island to do what they want to do."

Dr. Warshaw said he has great respect for the current hospital board and its accomplishments, not the least of which was raising the money needed for a new building.

Referring to some of the questions the MGH affiliation raised among the Island public, including the finances involved and loss of local control, Dr. Warshaw referenced an OpEd by Dr. Pieter Pil (Vineyard physician describes benefit of Partners affiliation, Oct. 26, 2006) published in The Times in which he described what an affiliation would mean in terms of improving the quality of care delivered to Island patients.

"I thought that the OpEd piece that Pieter Pil wrote was terrific," said Dr. Warshaw. "Because he got it."

The spur to the deal with MGH rested in part on timing, need, and complex federal reimbursement formulas.

The Nantucket and Vineyard hospitals are the state's only two critical access hospitals, a designation that negatively affects complex federal reimbursement formulas for all hospitals in Massachusetts, Partners hospitals foremost among them.

Under Partners' ownership, one of the Island hospitals must give up the critical care access designation. Partners, a $6 billion enterprise, is betting that the change will save it millions, should the formula be changed.