SYRACUSE, N.Y. — Crouse Health started affiliation discussions with hospitals in Jefferson and St. Lawrence counties “independently” during the spring of 2017, says Kimberly Boynton, president and CEO of Syracuse–based Crouse Health.

The hospitals included Carthage Area Hospital in Jefferson County, Claxton-Hepburn Medical Center in Ogdensburg in St. Lawrence County, and River Hospital in Alexandria Bay in Jefferson County.

Boynton notes that Crouse Health “quickly realized that River Hospital and Claxton-Hepburn Hospital had already formed an alliance.” That happened in 2015.

In its discussions with Carthage Area Hospital, Crouse Health also found that hospital was “very interested in also having the same conversation,” according to Boynton.

It all culminated with Crouse Health on Dec. 12 announcing affiliation agreements with the three Northern New York hospitals.

“You had three institutions that were like each other and in the same area and were more than willing to sit down at the table all at the same time,” says Boynton.

The affiliations “do not” represent a merger or acquisition, but instead allow each hospital to “strengthen patient services and share best practices and expertise,” Crouse contended in a news release.

None of the organizations involved wanted to develop a “fragmented system” where each hospital was affiliated with a different system, says Dr. Seth Kronenberg, chief medical officer at Crouse Health.

“So, I think because of the like-minded culture and the medical staffs all interacted very well and some similarities and synergies there, the opportunity to do something coordinated was very exciting for all of us,” says Kronenberg.

Both Kronenberg and Boynton spoke to BJNN on Dec. 14.

About the agreement

Under the affiliations, each institution will continue to operate as an independent, separately licensed, community-based hospital and maintain its existing board-governance structure.

Additionally, each hospital will continue singular responsibility for assets, operations, liabilities and budget. Labor agreements between each organization and its professional unions are “unaffected,” Crouse said.

When asked about the trend of affiliations among hospitals around the New York, Kronenberg said the state has encouraged such partnerships when it’s had to provide funding for financially “distressed” hospitals.

“They’re all doing well financially, so this was more motivated by how do we improve clinical services than it was … how do we do something for financial benefit,” says Kronenberg.

Through the affiliations, patients will have “access” to specialized care and physicians throughout Central and Northern New York. They will be able to see specialists from the hospitals participating in the agreement when needed, either in the hospital, in physicians’ offices or through telemedicine, which will be supported through Crouse Health’s affiliation with Northwell Health, which is headquartered in New Hyde Park, New York on Long Island.

The telemedicine option will enable diagnosis and treatment while “eliminating unnecessary travel time or delays” for patients in the North Country, according to Crouse.

Under the affiliation with Crouse Health, the Northern New York hospitals get the benefits of Northwell “through us,” says Boynton.

“The agreement that we signed with the three institutions with Crouse Health … states that they get the benefits of the Northwell relationship, but they don’t have a separate agreement with Northwell,” she adds.

“What we say is they’re affiliated with Crouse, powered by Northwell,” Kronenberg notes.

Already affiliated

Two of the hospitals involved in the Crouse affiliation already work together under a separate affiliation agreement.

River Hospital and Claxton-Hepburn Medical Center in 2015 entered into a cooperative agreement to affiliate. Like the agreement announced with Crouse, the arrangement “protects and enhances each organization’s respective mission, enhances the quality of services, increases efficiencies and lowers the cost of health care delivery in the St. Lawrence River region,” according to the Crouse Health news release.

In addition, Carthage and Claxton-Hepburn obstetrics departments already partner with Crouse Health on perinatal and neonatal intensive care through Crouse’s state-designated regional neonatal intensive-care unit (NICU) and status as a regional perinatal center. Under this partnership, many Carthage and Claxton-Hepburn infant patients are treated in Crouse’s NICU every year, the Syracuse hospital said.

The agreement between River Hospital and Claxton-Hepburn will remain in effect, along with both hospitals’ involvement in the Crouse Health affiliation, according to Kronenberg.

“This agreement is with all three separate entities,” he adds.

North Country reaction

The leaders of the three North Country hospitals had the following to say about the
affiliation agreements.

 “The river communities we serve are deeply aware of the need for, and value of, a strong local critical access hospital. The affiliation strengthens River Hospital by providing our patients access to a whole new level of specialized care,” Ben Moore, CEO of River Hospital, said in the Crouse release.

Richard (Rich) Duvall, CEO of Carthage Area Hospital, added, “From realigning the organization to serve its communities more efficiently and effectively to improving staff and finances, the board and leadership are confident that a clinical affiliation with Crouse Health, Claxton-Hepburn Medical Center and River Hospital will strategically position us for years to come.”

“An affiliation with Crouse Health, further backed by Northwell Health, will provide the tools we will need to successfully navigate upcoming health care challenges,” said Nate Howell, president and CEO of Claxton-Hepburn Medical Center.

Contact Reinhardt at ereinhardt@cnybj.com