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Public responds to possible Boone Hospital operators

People in mid-Missouri got a chance to see which groups might operate Boone Hospital Center for the next several years.

The hospital’s Board of Trustees hosted a public input meeting on Wednesday for people to discuss the five options the board will consider when renewing the lease for Boone Hospital Center. Boone County owns the 397-bed hospital and leases it to a health care company to manage daily operations.

The hospital’s lease with BJC HealthCare will end in December 2020. Board president Brian Neuner said the changing field of health care, stemmed primarily from the federal Affordable Care Act, led the board to open up its lease options to other groups. Negotiations with BJC continue, but the either party must decide by December 2018 whether it will keep its lease, change it or end it.

“We could remain with BJC, that’s certainly an option,” Neuner told the crowd. “But there are four other options, as well.”

Those options include Duke LifePoint Healthcare, a for-profit partnership between Duke University and LifePoint Health from Tennessee, St. Luke’s Health Systems, an Episcopal-affiliated network in Kansas City and MU Health Care. The board also considered running the hospital with a “stand-alone” governing body that would manage the hospital’s work.

Keith Hearle, a consultant from Verite Healthcare Consultants helping the board, said BJC wasn’t comfortable renegotiating the terms of the lease more than four years from its end. It had concerns with the lease structure, a five-year term that could be ended two years early, but said it was committed to serving the hospital as long as they were on the lease, Hearle said.

Members of the public had concerns with the others companies seeking to sign the lease. People felt Duke LifePoint’s position as a for-profit company put the public nature of Boone Hospital at risk. The company would form a joint venture for Boone Hospital Center, which would keep 20 percent of the profits, along with the rent money due to the county. Duke LifePoint would then get the other 80 percent.

Currently, Boone Hospital Center keeps half of all money made, while BJC and the board split the remaining half. St. Luke’s proposed paying rent based on a percentage of the money earned, while creating a new board of directors in which it would be the sole member.

Each group would keep all current employees of Boone Hospital Center, so long as they met some of the company’s internal requirements. Years of service would be honored in each plan, Hearle said.

Several people also raised concerns with MU Health Care taking over Boone Hospital Center. A “merger” would mean the end of health care competition in Columbia, many said, which could affect the quality and price of it in town.

“The idea of having a one-company town when it comes to medical care, I find difficult to understand why we would do that,” Roy Hartley said.

Some state oversight would be required if MU Health Care took the lease, said Elias Mastakis, a lawyer from Chicago helping the board. The state would ensure neither prices nor quality took a hit, as might happen with a monopoly, Mastakis said, and the legislature would need to pass a law to allow it.

Some university physicians spoke in favor of working at Boone Hospital Center. MU would be able to offer more than 1,000 beds if it began running Boone Hospital Center, and that would allow more flexibility in their ability to see patients. Dr. Timothy Fete, a pediatrician for MU Health, said their neo-natal intensive care unit has been full for the last month.

“If we had a closer collaboration, or however that works out, we would be able to flex,” Fete said. “And when Boone gets full, they could flex to the University.”

The board will still take public input on the options. It plans to begin negotiating with one of the candidates exclusively by the end of the year.

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