Declaration of independence

July 1, 2011
| By Pete Daly |
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The world of health care is currently expressed by “corporate models,” best exemplified by Spectrum Health’s aggressive affiliation of regional health care systems and physician groups. Community hospitals are locally best defined at Mary Free Bed Rehabilitation Hospital, which even recently re-emphasized its independent and specialized mission.

Last summer, Spectrum Health made an outright bid for Mary Free Bed’s affiliation only with Spectrum (an agreement that would not have included free association with Saint Mary’s Health Care or Metro Health, locally). It now appears the nationally known rehab hospital has no intention of being submerged in a larger organization, and will depend on a national network of referrals to maintain its current level of services, even as Spectrum begins construction of its own rehabilitation unit at the Blodgett campus.

In a press release in mid-June, the 120-year-old organization announced plans “to move forward with a bold vision to position Mary Free Bed Rehabilitation Hospital as a world-class center of excellence for rehabilitation. Mary Free Bed’s vision, according to Mary Free Bed Guild and hospital leadership, is to create the Mary Free Bed Rehabilitation Network, a geographic alliance of hospitals and providers formally integrated with an independent Mary Free Bed.”

The Mary Free Bed Rehabilitation Network will provide rehabilitation care for patients and families in west, mid- and northern Michigan through formal alignment with referring physicians and hospitals, according to the announcement. Major trauma centers will have minority ownership opportunities, but the Mary Free Bed Guild will be the majority partner.

“Patients have better outcomes and are more independent if they receive their rehabilitation care from Mary Free Bed,” said Kent Riddle, CEO of the hospital. “Mary Free Bed is the gold standard in rehabilitative care. Developing the Mary Free Bed Rehabilitation Network will extend our brand and expertise beyond the walls of the hospital to other settings, resulting in a seamless integrated system of care for patients.”

Riddle told the Business Journal that Mary Free Bed has “been talking to hospitals all the way to Flint, and as far north as the (Mackinac) bridge and as far south as Benton Harbor.”

“The idea is that we would be involved in increasing and improving the level of care in those communities with those community hospitals, in partnership. And then, for patients where the most appropriate care would be in our hospital here, those patients would come here,” said Riddle.

Mary Free Bed, he said, “is quite comprehensive, the most comprehensive rehab hospital in the state — actually, in the Midwest, probably, except for maybe Chicago. Because of that, we’re already serving patients all over Michigan.”

Some of the most difficult rehab cases, involving spinal cord and brain injuries, come to Mary Free Bed, Riddle said, including patients from Ohio, Indiana and even Canada.

Last year, Mary Free Bed served more than 7,500 individuals, he said.

“Mary Free Bed Guild’s 120-year history of providing hope and freedom to patients will endure and flourish within the network,” said Julie Ridenour, president of the Guild.

Members of the guild and hospital boards voted in June to adopt the vision and network plan. Further details regarding the network will be forthcoming.

“The ideal system of rehabilitative care will expand the high quality of Mary Free Bed’s care to a broad regional network, help train the next generation of health care rehabilitation professionals, and promote innovative treatments and cures through research,” said Dr. John Butzer, chief medical officer. “This is a great step forward to providing state-of-the-art rehabilitative care for more people in Michigan.”

“Mary Free Bed will continue to do what we do best, in more places, and we will do it better than ever,” added Riddle.

Last year, the Business Journal reported that the guild was reportedly resisting overtures from Spectrum Health to become part of that organization. Later that summer, a draft business plan at Spectrum was anonymously leaked to the news media, revealing an internal proposal for a rehab program at Spectrum’s Blodgett facility. Such a move could have taken patients away from Mary Free Bed, which has 80 beds and is located adjacent to Saint Mary’s Health Care in downtown Grand Rapids (although there is no legal relationship between Mary Free Bed and Saint Mary’s.)

In 2009, Spectrum Health’s Grand Rapids facilities provided more than half of Mary Free Bed’s inpatient volume and about 40 percent of rehab patients are referred from Metro Health.

Michael LaPenna, founder and principal of the 25-year-old LaPenna Group Inc., said Mary Free Bed’s network announcement may represent a defiant declaration of independence. Mary Free Bed “is very well thought of and has a terrific reputation” throughout the U.S., according to LaPenna, a health care consultant with clients throughout the nation. He is one of Michigan’s top experts in health care systems business development.

Although LaPenna had no involvement with the talks last year between Spectrum and Mary Free Bed, and had no direct inside knowledge of the proposals that went nowhere, people who were involved did ask him privately for his opinions.

“I know there was a great deal of discussion,” said LaPenna.

Mary Free Bed’s announcement about a new rehab network throughout much of the state “intrigued” him, LaPenna said, “because this obviously signals to everyone that they’re going to be independent. And, in fact, they used the word” in the announcement more than once.

LaPenna said the transformation of health care in the United States — plus budget constraints, declining reimbursement and declining population in Michigan — are combining at this time to “increase the anxiety” of health care organizations, and many are “becoming conservative, sort of holding-in-place, waiting to see what is the next national step. But, apparently, not Mary Free Bed.”

“Now comes Mary Free Bed, saying, ‘We’re different. We’re going to do our own network and we’re going to be independent of everyone — reach out across the state and develop a whole new thing,’” said LaPenna.

To launch a “new initiative in health care” at this time is “exciting and interesting and bold and risky,” said LaPenna

Mary Free Bed Guild was a group of Grand Rapids women who came together in 1891 in recognition of the need for medical care for patients of limited means in the community. They began by soliciting donations from women in the city who were named Mary — and also from people who had friends or relatives named Mary. The plan was to use the money to secure the use of one free bed in a local hospital. The Mary Free Bed fund grew, along with the need in the community for more such beds, and the group incorporated in 1911.

In the 1930s, the guild opened a 12-bed children’s convalescent facility on East Fulton Street, and the organization continued to grow. In 1960, the institution began offering outpatient services for children and then expanded into adult rehab care in the late 1960s.

The existing Mary Free Bed hospital was built in 1976, connected to Saint Mary’s so that cafeteria services could be shared between the two institutions.

Also, said Riddle, “having a connection to an OR made sense in case of emergencies.”

Mary Free Bed was awarded the 2009 Michigan Quality Leadership award and has been recognized as one of the 101 Best and Brightest Companies to work for in West Michigan.

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