Fairview Health Services and the University of Minnesota are going through a terrible breakup.
As with many breakups, one wonders: What about the kids?
By kids, I mean the doctors and nurses and the thousands who work for the system known in recent years as M Health Fairview.
And the rest of us.
Minnesota’s healthcare scene is hip to Fairview’s November announcement that it would merge with Sanford Health, the Sioux Falls-based system that dominates health care in the Dakotas and western Minnesota.
The University of Minnesota, whose hospitals have partnered with Fairview for 27 years, said last week that it wants its campus facilities back, the merger would have to wait, and that it needs a lot of money from us kids.
In a brief press conference on Thursday, U leaders presented a “vision of innovation” that was lacking in detail, especially cost. There was confusion about the ongoing work with Fairview. Were it not for the Fairview-Sanford deal, I suspect U leaders would have waited to unveil this vision.
“The proposed Fairview-Sanford merger calls for a more comprehensive discussion of how the state, university and health care providers can and should put the health of Minnesotans at the center of upcoming decisions,” said Myron Frans, chief finance officer at the u. the press conference.
It never does.
The U’s vision includes a new $1 billion-plus hospital on the Minneapolis campus and spending that is sure to be hundreds of millions more to improve other hospitals. Getting US hospitals out of Fairview can also be costly. A legal battle seems likely.
Two big questions with no real answer hang over the whole drama.
First, why weren’t the U and Fairview, after all these years of working together, on the same page when Sanford arrived? They had already been there. The state and U halted a proposed merger between Fairview and Sanford 10 years ago.
“They didn’t tell us about it when they started” the new merger talks, Frans said. But it was certainly discussed within Fairview’s board of directors, which includes Frans and U.S. dean of medicine, Dr. Jakub Tolar, before emerging publicly last November.
And then, in a note to employees after Thursday’s press conference, Fairview CEO James Hereford said he had not been briefed on the U’s new plan. “The University’s comments raise significant questions about its desired future with Fairview.” , he added. The AU spokesman said Fairview leaders were briefed a few days earlier.
Secondly, why are Fairview and Sanford in such a hurry to close the deal? Executives say they aim to conclude it in March, four months after the November 15 signing of the non-binding letters of intent.
Two possibilities. There are business reasons for the opportunity, with Fairview keen to cut its operating losses and Sanford looking to hammer out a deal after recent merger attempts with systems in Utah and Iowa failed. The other possibility is that they want to make the U act, a slower moving entity.
Top executives at Fairview and Sanford say they will save Minnesotans money by combining their systems, but haven’t shown how. With more time, perhaps they will.
Underlying this breakup are hard truths about Midwestern change.
Healthcare is becoming increasingly difficult to provide in rural areas. The prospect that some Minnesota cities could lose their hospitals or doctors scares political leaders. The U, Fairview and Sanford all profess a commitment to rural health, but neither can guarantee that they will be able to maintain service in all locations.
And, as I noted in my first article two weeks ago, Minnesota’s population is stabilizing and its economy is slowing down. This will force tough compromises, perhaps over building a new hospital at the U. When Frans started the U press conference by mistakenly saying that Minnesota has one of the fastest growing economies in the nation, it was another sign of the disconnect between the people driving this story and the rest of us.
Fairview, Sanford and the U have competing ideas for navigating all of this. Now we can see that they didn’t resolve them before the conflict spilled out into the open.
Of course, all the subtleties have been observed and all the leaders have said that they are willing to talk to each other. But nobody in this is completely direct and open with the public.
It must have been very daunting being an employee in the M Health Fairview system last week.
And what about the rest of us “kids” in this breakup? It is obvious what will happen to us. Everything the leaders of Fairview, Sanford and U are doing right now will make health care more expensive in Minnesota.