"I was disappointed..."
COLUMBIA, Mo 2/22/18 (Interview) -- After he denied allegations of backroom deals with legislators to forge a two-hospital merger, Boone County Hospital (BHC) Board candidate Greg Steinhoff  addressed the County Hospital's "deteriorating situation," with or without Mizzou. 

Merger opponents including area healthcare providers worry a single MU-Boone hospital will monopolize healthcare, driving up patient costs and forcing out practitioners. 

Steinhoff discussed their concerns and others in this multi-part exclusive interview:  Part One, Part Two, and now this conclusion. 

A former BHC Trustee, Steinhoff (photo below) left that position in 2005, when "the hospital was...performing very well in virtually every metric," he told the Heart Beat.

On returning in 2017 to fill out a term Fred Parry lost when he was elected Southern District County Commissioner, "I was disappointed that there was a completely different situation," Steinhoff explained.  "Most concerning were the financial condition and trends.  Patient satisfaction was on the decline, physicians were upset (some extremely unhappy)."  And almost everyone, Steinhoff added, was dissatisfied with the hospital's management firm, BJC Healthcare.  

To reverse a "deteriorating situation, we looked at five options that would impact or improve the performance concerns, and enable Boone to fulfill its mission of improving the health of the people and communities we serve." 

MIKE MARTIN, COLUMBIA HEART BEAT:  If a merger is NOT in the offing now, what do you see as the future of Boone Hospital?

STEINHOFF:   I presume the Trustees will go back to the drawing board and begin choosing a path that delivers.  The Trustees (including myself during my 4-month interim term) spent an enormous amount of time analyzing Boone, the strengths and weaknesses of each of the options and trends in healthcare. 

COLUMBIA HEART BEAT:  Why would you support a merger?

STEINHOFF:  Based on the analysis of BHC and each option, I understand why everyone who consulted, provided legal counsel, outside hospital executives, and the other Trustees were compelled to recommend discussions with University Hospital at MU. 

BHC is no longer an island in the middle of Missouri.  We’ve been that, we are losing that.  More than 15,000 patients a year are now leaving our area to receive services elsewhere. 

KU Medical Center is spending more on advertising in Boone County than BHC.  St. Lukes, St. Johns and other hospital systems are developing relationships with traditional Boone and/or MU allies in Kirksville, Moberly, Marshall, Lake Ozark General and others. 

We are trending toward mid-Missouri becoming a feeder system to the metros of Kansas City, St. Louis, and Springfield, as opposed to those hospitals feeding Boone.  This should concern everyone, healthcare providers or not.

Nationally, there is a trend toward strong academic/community hospital systems.  BJC is number one in Missouri, with Washington University Medical School at its heart. 

KU Medical Center is the #1 hospital in Kansas.  Same with Baylor Medical Center throughout Texas; Colorado Health -- Univ of Colorado and Poudre Valley Health System -- in that state; Vanderbilt Medical Center in Tennessee; Indiana Health in Indiana; and Duke University-Lifepoint in North Carolina. 

And these are just the ones we looked at.

We don’t want to jump on a bandwagon, but it is important to understand how and why these systems are forming and what causes them to be seemingly better equipped for the changes in healthcare.

I think it’s also interesting that BHC isn’t or hasn’t been the only one talking merger with the University, but is being called out on it
The largest private practice surgical group in Columbia merged with the University (speak with Dr. Paul Humphrey and listen to his thoughts).   The largest family practice group in Columbia also recently merged with the University.  

Mergers often allow for greater efficiencies and better service as per this quote from Phillip Smith when he merged his company with [my opponent] Mark Dempsey to form Peak Sport and Spine

“We’ve always had a mutual respect for each other,” Smith said. “But as former competitors, it was challenging at first to admit that we could do better working together than we could working against each other. As we learned more about each other’s values and belief systems, it was clear we had the same goals and objectives."

COLUMBIA HEART BEAT:  Why would you oppose or question a merger?

STEINHOFF:   Would we be able to attract the leadership necessary to build this kind of system? 

Where is the competition? 

Can the University realize they need this type of relationship? 

Is it healthy for a university system to derive a large percentage of their revenues from healthcare (many would say a high risk industry)?  

A $1B system is relatively small.  Will it be successful 10 years from now, when the state still isn’t allowing them to raise tuition or increase funding and universal healthcare has cut their hospital funding? 

What about the quality of the medical school?  How would that be enhanced or hurt by the two hospitals working together?

When do you cross the threshold in this mid-Missouri healthcare industry where it’s more important to make the decision that Smith and Dempsey made [when they merged their firms to form Peak Sport and Spine] which is:  We have a better chance of fulfilling the mission if we work together?    

Parts 1 and 2: