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BayCare grows into the future with dominance

Whether you're a Brandon man who needs open-heart surgery, a Clearwater woman with a sleep disorder, a Lutz teen wanting a soccer checkup or a Tampa mom facing a high-risk birth, chances are you'll get care at a hospital or clinic bearing the BayCare name.

BayCare Health System is now the biggest health care provider in the Tampa Bay area, controlling more than a third of all hospital business here. Over the weekend, it marked the one-year anniversary of its St. Joseph's North in Lutz, the first all-new, full-service hospital in the area in 30 years. And BayCare is still growing, with another hospital soon to break ground in Ruskin.

The nonprofit corporation got its start 13 years ago when a group of area hospitals joined forces to better compete with a big national chain, Columbia/HCA Healthcare. Now, BayCare easily outstrips HCA here.

Analysts say it's unusual for one company to control such a big slice of one region's health care pie. But BayCare represents a major and growing trend in health care, a field in which more than ever, size matters.

It's long been the case that big companies often can drive harder bargains with insurers.

Now, as the nation grapples with soaring health care costs, size matters in a new way. As government cuts reimbursements for Medicare and Medicaid, and as new models of care come along, some experts say health systems that are large and diverse will be best able to cope.

What does the trend mean for patients? On the plus side, there's the potential for more cost efficient, better coordinated care. A high quality provider also can help keep standards up around the area as others seek to stay competitive. And BayCare's many facilities allow it to be a presence both in well-established areas and newer suburbs.

"It's about serving the entire community, from being where they live to providing advanced, superior care," said Steve Mason, BayCare's president and CEO. "We've always felt that if we're going to improve health, we're going to be in the community."

Jay Wolfson, a health policy expert at the University of South Florida, praises BayCare for strong management and excellent patient care. But he says that patients eventually could have fewer choices if insurers no longer include smaller systems in their networks.

Plus, he says, BayCare's size could give other providers incentive to merge into bigger, more competitive corporations, too.

• • •

BayCare includes some of the area's most established hospitals: Morton Plant in Clearwater, St. Anthony's in St. Petersburg, and St. Joseph's in Tampa.

It also operates more than 100 other facilities, including outpatient centers, urgent care clinics, labs and physician offices spread throughout Tampa Bay.

With 18,500 "team members," as it calls employees, it's the area's second-largest private employer, behind only Publix. More than 2,500 physicians have admitting privileges at its facilities or are employed by BayCare, which is rumored to be in talks to acquire a large physician practice, St. Petersburg's Suncoast Medical Clinic.

In 2009, BayCare sent home 118,000 people from stays in hospitals, performed 52,000 outpatient surgeries and handled 409,000 visits to its emergency rooms.

Those numbers give BayCare a 34 percent share of the local health-care market, followed by HCA's nine area hospitals (27 percent), Tampa General Hospital (11 percent) and University Community Health (9 percent). It brings in more than $2 billion in revenue and has strong bond ratings, an indicator of its solid financial health.

For a time, St. Petersburg's Bayfront Medical Center, which has 4 percent of the market, was a BayCare member. But in 1999, City Council members (Bayfront sits on city property) learned the hospital curtailed abortions because of BayCare's Catholic ties. The city sued Bayfront for violating separation of church and state, and the hospital left BayCare, which provides only limited abortion services.

Today, Bayfront is independent, and president and CEO Sue Brody says that fact makes it more responsive to the community's needs — while still able to compete.

"By being part of programs that leverage our buying and negotiating powers, we benefit in the same way as larger corporate systems — especially when it comes to purchasing supplies and other economies of scale considerations,'' she said.

• • •

Among BayCare's major recent projects: the area's first free-standing emergency room in Largo (opened in 2008); a 52,000 square-foot outpatient center in Westchase (2009); and two new buildings at its Morton Plant North Bay Hospital in New Port Richey (2010). Its most visible addition was St. Joseph's North, a $224 million, 350,000-square-foot facility opened last year.

Major projects under way include a 100,000 square-foot emergency center at St. Anthony's, a 103,500-square-foot addition to Morton Plant, and a neonatal intensive care unit expansion and a new breast center at St. Joseph's Women's Hospital.

In the next year, BayCare expects to break ground on another new hospital, tentatively named St. Joseph's South, in Ruskin.

• • •

BayCare's growth strategy puts facilities where they are convenient for patients, while also saving money, Mason explained, because having outpatient and urgent care centers helps keeps patients out of more costly in-patient hospitals.

Patients also have easy access to a network of special expertise, said Dr. Bruce Flareau, a BayCare vice president and family physician. So, for instance, a patient from Hillsborough with a challenging heart problem might be sent to Morton Plant, which has been named a top 50 hospital for inpatient cardiovascular services by Thomson Reuters, the only hospital to make this list for the last 12 years.

But for all its size, BayCare doesn't provide all levels of care. Tampa General Hospital, for instance, is an independent with the area's only Level I trauma center, the area's only burn unit, and it's the primary teaching affiliate of the USF medical school.

And Bayfront's Brody points out that her hospital has services and programs, including Level 2 trauma, that aren't available anywhere else in Pinellas County.

"We do so because they are critical services our community needs and the nimble flexibility that comes with independence makes it possible,'' she said.

• • •

Josh Kelley is an analyst with HealthLeaders InterStudy, which compiles health care market information for 87 cities and metropolitan areas in the United States.

He said in markets the size of Tampa Bay, it's unusual for one provider to have a 34 percent share. More typical, he said, is Miami-Broward, where HCA and Memorial Healthcare each have about a 16 percent share, followed by Baptist Health, with 13 percent.

But insurers can't ignore BayCare's clout in negotiating longer-term contracts, said Lee Bowers, vice president of network management for insurance giant Humana.

"It would be harder to sell a health insurance product without (BayCare)," Bowers said.

Wolfson, of USF, says BayCare's size could inspire more mergers.

"I see BayCare as creating reasons for Adventist to talk to USF, or to talk to Tampa General. Or for HCA to talk to others," Wolfson said.

He pointed to two events in the past year: Winter Park-based Adventist HealthCare acquiring Tampa's University Community Health, and All Children's in St. Petersburg joining Baltimore's Johns Hopkins Health System.

As BayCare continues to grow the question becomes whether it will draw even more market share, Wolfson said.

Mason says that's not the goal, noting BayCare's market share hasn't risen substantially in the past several years and may not for some time.

"As the market grows, even though we may have the same market share, we'll see more people," Mason said.

Richard Martin can be reached at rmartin@sptimes.com or (727) 893-8330.

BayCare grows into the future with dominance 02/20/11 [Last modified: Monday, February 21, 2011 6:56am]
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