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UMMS takes over emergency rooms in P.G.

The Prince George’s County Health System is growing closer to an affiliation with the University of Maryland Medical System after a recent emergency room management takeover, but an official agreement for UMMS to absorb the county’s hospitals has not been finalized.

The proportion of patients without insurance or using Medicaid at Prince George’s Hospital Center is significantly higher than the state average.

UMMS took over emergency room operations at Laurel Regional Hospital July 1. It is expected to begin managing emergency services at the Prince George’s Hospital Center in Cheverly in August, as well as at the Bowie Health Center in 2013.

A July 2011 memorandum of understanding laid out a plan for the collaboration between UMMS and Dimensions Healthcare, the company that runs the Prince George’s Hospital System. The memorandum set forth plans for the construction of a new hospital and for the improvement of Dimensions’ facilities.

The UMMS network comprises 12 academic, community and specialty hospitals in Maryland.

“They were working to see if they could come up with an agreement to run the whole hospital system,” said Simon Powell, a state budget analyst for the Department of Health and Mental Hygiene.

Such an agreement, he said, has been “talked about for some considerable time” in Maryland, but has yet to see an official solution.

As a part of the memorandum of understanding, UMMS agreed to assist Dimensions from a consultative standpoint, said Mary Lynn Carver, senior vice president of communications and public affairs at UMMS, and the management of emergency services is an example of that consultation.

As for adding the three hospitals to the UMMS network, she said, “That all is still being discussed and planned depending on what the needs are. No decisions have been made.”

However, the change in emergency services is the most far-reaching development to date in relation to the 2011 memorandum, said John O’Brien, chief operating officer of Dimensions.

There are “consulting reports back as early as mid-’90s that suggest that this affiliation was the way to go,” said O’Brien. “There is nothing assumed, but we are moving on this track, which should lead to a new hospital and an affiliation.”

Dimensions has been operating emergency services in Laurel, Bowie and Cheverly under three different contracts. The new single contract with UMMS should create a more efficient emergency care system, said O’Brien.

“Overall it’s going to help us improve the quality and service,” he said. “For the first time we’ll have a consistent, single medical direction for each of the sites.”

Another expected advantage of this change is that more patients will come to Dimension’s hospitals for emergency care because of the association with UMMS.

“The emergency department team from the U of M manages many emergency departments across the state and are very expert in doing so,” said Carver. “Anything that can be done to streamline … will of course increase consumers’ likelihood to use those services.”

Dimensions has experienced a multitude of financial issues, including a “disadvantageous” payer mix, according to a 2012 Maryland report.

The proportion of patients without insurance or using Medicaid at the Prince George’s Hospital Center is significantly higher than the state average. In 2004, for example, 49.9 percent of inpatient cases were Medicaid recipients or self-paying patients, while this percentage was 22.5 statewide.

The Prince George’s County Health System has relied on support from the state and county in recent years to avoid deficits, bankruptcy and even closure of its facilities. In 2008, the state and Prince George’s County committed $150 million in operating funds over five years and $24 million in capital funds over three years to the system.

The next steps under the 2011 memorandum depend on the results of a community health assessment of Prince George’s County by the University of Maryland School of Public Health, an analysis of the financial feasibility of a new Prince George’s Hospital Center and an economic impact study.

If these results suggest that a new regional hospital center should be built, the plan is that UMMS will file a certificate of need to build it, said Carver.

O’Brien said that Dimensions is also discussing three other specialty areas in which UMMS may be able to provide services, but would not say what they were.

“It’s an exciting time to be in health care in this county,” said O’Brien. “It’s unlikely that this arrangement would be thrown off the track that it’s on.”