Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, January 26, 1994 TAG: 9401260158
SECTION: CURRENT PAGE: NRV-1 EDITION: NEW RIVER VALLEY
SOURCE: BRIAN KELLEY STAFF WRITER
DATELINE: LENGTH: Long
Agency staff also gave a thumbs-down to Radford Community Hospital's competing application to build a $3.4 million center on Virginia 177, where hospital officials want to move their entire operation by 1998.
The agency's 25-member board of directors will meet Feb. 2 in Roanoke to recommend to the state health commissioner whether either proposal merits a certificate of need. Representatives from both hospitals will be able to make their cases then.
The two hospitals are fighting for a cancer center they say is needed for residents of the New River Valley and Carroll and Wythe counties who must otherwise drive to Salem or Roanoke for radiation therapy.
The Pulaski proposal would also serve residents of Bland, Grayson and Smyth counties and Galax.
The competition pits the Roanoke-based Carilion Health System, which owns Radford Community, against HealthTrust Inc., a Tennessee-based corporation that also owns Montgomery Regional Hospital.
Pulaski Community Hospital Administrator Christopher Dux was cautiously optimistic Tuesday.
The recommendation meant that key health planners decided Pulaski had the greater demonstrated need "and our project has significant advantages over the Radford proposal," Dux said.
Dux was less sure how significant the staff recommendation will be in the overall decision.
Andrew Cochrane, executive of the family care center at Radford Community, said officials there still feel very positive about their chances.
"Obviously we're somewhat disappointed by this first decision," Cochrane said. But "it's the first step of many in the process."
Even if Radford doesn't win its bid for the cancer center, it will have no bearing on plans to build a new hospital, Cochrane said. Radford Community is still on schedule to submit a certificate of need application to the state next year for that project.
The health systems agency staff cited nine reasons its board should give Pulaski the nod, including that it is centrally located for 27 percent more people than Radford's site near Interstate 81.
Moreover, the staff said 45 percent of the people in Radford's service area already live within an hour's drive of centers at Roanoke Memorial Hospital and Lewis-Gale Hospital in Salem.
The report also found Pulaski's plan to build its unit onto the existing hospital as having advantages, such as easier patient access, over Radford's unit being at a separate location. And the staff said the type of radiation equipment that Pulaski wants to buy, though more expensive, may be more flexible in the long run than Radford's proposal, which will be a rebuilt version of an earlier generation of machine.
Also, Pulaski Community's center, because it is projected to draw more treatment visits by its second year, should have a lower unit cost and cost per treatment, according to the staff report.
Because Pulaski Community will be operating in conjunction with Lewis-Gale Hospital, it will be drawing patients from there and reducing the need for Lewis-Gale to purchase an additional unit, the staff said.
But, according to the report, giving the certificate to one hospital alone may not be the best route.
Instead, a joint venture would benefit the hospitals and patients alike, though four months of negotiations between the hospitals ended last month without agreement.
A joint venture would dovetail with the nationwide movement toward employers setting up managed care networks with hospital systems. In other words, if Pulaski gets the center and a cancer patient affiliated with Radford's network seeks treatment there, he may incur "significant out-of-pocket expenses," the report states.
"It would serve the patients . . . much better if there was one joint cancer center from which all patients could obtain care without financial penalties," health planners noted.
Radford Community, which initially wanted to build its center in Christiansburg, tossed its hat in the ring last year in competition against Lewis-Gale Hospital, which wanted to expand its cancer treatment center in Salem.
Though the health systems agency that time favored Radford's proposal, Health Commissioner Robert Stroube denied both applications in August.
Meanwhile, Pulaski submitted the current application and Radford renewed its application, but amended it to move the site to Virginia 177 in Montgomery County, 1 1/2 miles south of Radford.
Concurrent with the Southwest Virginia Health Systems Agency board's work, a state Health Department official is also studying the proposals to make a recommendation to the health commissioner.
If either the board or the state Health Department recommend denial of an application, the matter will automatically go before an informal fact-finding conference. There, an independent hearing officer will decide if the recommendations were correct and make his own recommendation to the health commissioner.
Once the commissioner issues a ruling, which could come by late spring, there's still another route of appeal through the state court system.
Staff writer Paul Dellinger contributed information to this report.
by CNB