THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Saturday, January 28, 1995 TAG: 9501280250
SECTION: LOCAL PAGE: B1 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Medium: 85 lines
Acknowledging the passing of an era, 150-year-old DePaul Medical Center has decided to affiliate with an insurance network, officials confirmed Friday.
DePaul, Norfolk's independent, Catholic hospital, is negotiating with Richmond-based Trigon Blue Cross Blue Shield and Tidewater Health Care of Virginia Beach.
DePaul is not being bought out, said Kevin P. Conlin, the hospital's chief executive officer, but will join forces with health maintenance organizations owned by Trigon and Tidewater Health Care.
The deal, which is in the final stages of negotiations, is a recognition that hospitals can't go it alone in the changing world of managed health care.
``Our underlying goal (is) to improve the health status of the community. In order to do that, we feel we've got to be part of a health system,'' said Conlin.
By affiliating, DePaul will be assured of getting patients through the HMOs.
In return, Trigon and Tidewater Health Care, which owns Virginia Beach and Portsmouth General hospitals, are guaranteed access to a hospital in Norfolk. The city's other acute-care hospitals, Norfolk General and Leigh, are owned by rival Sentara Health System.
``We have to have a secure way that, in the long run, will make hospital services available to beneficiaries of our insurance program and complement what we're doing in Virginia Beach,'' said Douglas L. Johnson, president of Tidewater Health Care.
It's the second recent coup for Tidewater Health Care. Just three months ago, the company reached an agreement to combine its HMOs with those owned by Trigon, the state's largest health insurer. That deal is supposed to be finalized in February.
Right now, arrangements like this will mean very few practical changes for most local patients. Only about 10 percent to 20 percent of local residents are in any kind of managed-care plan, and Tidewater's and Trigon's combined HMO network will have only about 50,000 members.
But someday, health care leaders say, Hampton Roads will be dominated by a handful of managed-care companies, and all hospitals and most primary-care doctors will be aligned exclusively with a particular insurer.
Insurers like Tidewater, Trigon and Sentara are jostling to make sure they are among those dominant companies, and, like kids on a baseball diamond, hospitals and doctors are starting to choose sides.
In addition to the arrangement with insurers, DePaul is going to deal with doctors in a new way.
Some will actually become employees - the hospital is negotiating to buy several local doctors' practices, although contract requirements prevent Conlin from revealing any names until the deals are final. Even those doctors who remain independent will in many cases work exclusively with DePaul.
All this reorganization has required long and delicate negotiations, and not just about financial matters.
DePaul faces a philosophical question: How does the Catholic hospital make sure the practices of its new associates don't conflict with its own mission?
Birth control, for example, is a difficult issue.
DePaul, while operated independently by a local board, is owned by the Daughters of Charity system, a Catholic network with more than 40 hospitals scattered around the country.
Catholic values, including the ban on artificial birth control, are inherent in DePaul's mission. The hospital won't perform sterilizations, and officials don't plan to change that after the affiliation.
But many primary-care doctors do prescribe birth control. If some are to become employees of the hospital, DePaul must decided how to deal with that contradiction.
``That's something we're in the process of resolving now,'' said Conlin.
And DePaul officials accept that Tidewater Health Care's doctors and hospitals don't operate under the same birth control ban.
``We know it's going to happen. We don't approve of it . . . (but) we do understand it's done elsewhere,'' Conlin said. MEMO: In Sunday Business: Sentara Health System has moved steadily toward the
future of the managed-care industry in an effort to keep its position at
the top.
KEYWORDS: DEPAUL MEDICAL CENTER HEALTH CARE MANAGED CARE HMO
HEALTH INSURANCE by CNB