Affiliation talk

Tim Horan • Reflector-Chronicle

Elgin Glanzer, chief financial officer of Memorial Health System, explains the difference between an affiliation which MHS is looking into with Salina Regional Health Center, and a buyout/merger which is not what is being proposed, at the regular meeting of the board of directors Tuesday.

Population Health and global payments will change the way health care is funded and operated.

“We know that it is coming down. We just don’t know what it will look like when it gets here,” Harold Courtois, chief executive officer of Memorial Health System, told the board of directors at the regular meeting on Tuesday.

However, those changes coming from the Medicare, Medicaid and other insurance companies are the key reasons that Memorial Health System is investigating an alliance with Salina Regional Health Center.

Board Chairman Dr. Steve Schwarting added a public comment to the meeting’s agenda for affiliation discussions, something he said he was going to continue at future meetings.

Courtois started off by reading a statement.

“No one is sure what Population Health will look like in the future, but we know that it is coming, and it will require a population of more than 50,000 people,” he said. “Not one health system in North Central Kansas has that kind of population on its own, which means that affiliations are necessary to mitigate risks when Population Health becomes the way hospitals and providers are paid to care for patients.

“Right now, we are doing our best to look ahead and plan for the next 10 to 20 years. We are asking ourselves, ‘How do we achieve a level of population (of 50,000) and provide all the benefits of continuity of care, quality, cost, and access?’ Affiliation is a path which provides all of these factors. It is a benefit of being part of a larger organization.

“This decision is about preserving the personal care of the people we love in our community and doing it alone is no longer guaranteed,” he said.

Attorney Jim Angell said so far there is no agreement to refer to. However, any agreement would have to comply with Kansas laws, he said.

“We haven’t got to the point where we are looking at documents yet,” he said.

Angell was called to the Memorial Health System team because attorney Peter Johnson also represents Salina Regional Health Center.


Population Health

Courtios said Population Health could mean global payments. Funding will be provided for Medicare and Medicaid, which could probably come in 12 monthly payments.

“Then you are responsible for the care of that patient for the entire year, no matter if they are served at your hospital or somebody else’s,” he said. “That becomes an issue of grouping together makes you stronger if you are an affiliated organization.”

“The one thing I know we will get away from is pay for volume. That is unsustainable in the country and we all know that,” he said.

He said MHS would be concerned about the number of people visiting the clinic and the hospital.

“Now you are paid for all the people in your area and you focus more on preventive health rather than reactive health,” Courtois said.

Dr. Bill Short, chief medical officer, said the current incentive is to treat sick people “because we get paid for more people to come into the office and are sick which seems really messed up.

“Population Health is designed to incentivize you to keep the population healthy,” he said. “You are paid a certain amount for the people that you are serving and it is better for us to keep those people healthy.”

He said with that model in a small market, one person who gets sick and spends $1 million on their health care at Salina Regional could cost us a lot of money, he said.

“Assuming that risk in a bigger population is a better solution,” Short said.


Affiliation vs. 


Asked about the difference between an affiliation and a buyout/merger, Elgin Glanzer, chief financial officer, said in an affiliated Memorial Health System would continue to be locally owned and decisions will continue to be made locally while in the buyout merger, decisions would not be made locally. Also an affiliation can be reversed while a buyout/merger could not.

With an affiliation, the board of directors would continue to be elected.

In his statement, Courtois said, “At Memorial Health System, we see ourselves as a family, caring for our friends and neighbors, ‘people you know, caring for people you love.’  As we move into the future of health care, we want to provide the best health care for our patients. Our recent decision to enter into an affiliation investigation with Salina Regional Health Center, is exactly that – an investigation. We want to know if affiliation would allow us to be a better Health System. We want to provide the best health care for our patients, and be the best family for the people who work here.

“The best health care means: accessible health care at a reasonable cost with exemplary quality. The best health care also includes a common Electronic Health Record for patients, allowing providers (from other hospitals and clinics in the area) the ability to provide patients with continuity of care. Consistency and best practices would be in place, because access to vital patient information would be available to all providers making informed decisions about the health and wellbeing of their patients. The desire is to coordinate protocols and processes for chest pain, stroke, and trauma, and other health issues, to ensure the best possible outcomes. 

“Why us? Because going it alone in health care is becoming more difficult. We are stronger together. “

“Why me? So you can continue to receive the best possible care when needed.

“Why this? Because we can maintain some local control while accessing a larger organization’s expertise.

“Salina Regional Health Center has already affiliated with the hospitals in Lindsborg and Concordia. As a result, both Lindsborg and Concordia hospitals have experienced growth and positive outcomes. We will continue to investigate this opportunity, and we will make sure that if we proceed, it is because together it is the right time, right place, and right care for our community,” he said.

Contact Tim Horan at


Contact Tim Horan at

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