The most significant benefit
of the affiliation is for patients with complex medical
needs who require tertiary care or specialty services unavailable
on the island.
patients now have a direct link to caregivers and services
at the MGH, offering better coordination of care and services
through such means as a shared electronic medical record
and an expanded pool of consulting sub-specialists. In addition,
the MGH will work closely with the hospital to identify opportunities
to enhance the services available on the island.
Lucille Giddings, RN, President and CEO of NCH notes, “Throughout our strategic
planning process, we learned from members of this community that MGH is the favored
Boston medical facility.” She adds, “This is an unprecedented opportunity for
our patients and staff – and, in fact, our entire community – that our hospital
has affiliated with such a premiere healthcare facility.”
MGH physicians have long consulted at NCH, seeing patients on a regular basis
on the island. Additionally, NCH has experienced long-standing clinical collaborations
with the MGH in such specialties as cardiology, neurology, dermatology and emergency
services. Additionally, NCH is connected to the MGH through telemedicine links.
In addition to the clinical benefits, under the terms of the affiliation, the
MGH and Partners have agreed to contribute $5 million to NCH to help it address
specific capital needs. Also, the affiliation with the MGH and Partners could
facilitate a change in Medicare designation for the island hospital. This change
could ultimately benefit hospitals throughout Massachusetts, including the Partners
David F. Torchiana, MD, chairman and CEO of the Massachusetts General Physicians
Organization, says that patients, not finances, have been central to the discussions
with physicians at NCH. “The doctors who practice in Nantucket share a very special
bond with their patients, and we must make sure that this vital doctor-patient
relationship is protected and preserved,” he says. “The affiliation is not meant
to be disruptive of pre-existing clinical relationships or referral patterns.
Rather we want to work closely with the hospital to identify gaps in care and
determine how the MGH can help fill in those gaps as well as reinforce or add
services that will be helpful to the island community.”
About Nantucket Cottage Hospital
Nantucket Cottage Hospital is a not-for-profit critical access hospital that
serves an island community 30 miles from the mainland. Founded in 1911, the 19-bed
hospital maintains a deep tradition of providing high-quality care to a population
of 10,000 full-time residents that increases to more than 50,000 in the summer
months. The hospital admits more than 600 patients a year, and records nearly
50,000 outpatient visits and more than 11,000 emergency visits.
About the Massachusetts General Hospital
Founded in 1811, the MGH is the third oldest general hospital in the United States
and the oldest and largest in New England . The 900-bed medical center offers
sophisticated diagnostic and therapeutic care in virtually every specialty and
subspecialty of medicine and surgery. Each year the MGH admits more than 46,000
inpatients and handles nearly 1.5 million outpatient visits at its main campus
and health centers. Its Emergency Department records nearly 80,000 visits annually.
The surgical staff performs more than 35,000 operations and the MGH Vincent Obstetrics
Service delivers more than 3,500 babies
each year. The MGH conducts the largest hospital-based research program in the
country, with an annual research budget of approximately $500 million. It is
the oldest and largest teaching hospital of Harvard
Medical School , where nearly all MGH staff physicians serve on the faculty.
The MGH is consistently ranked among the nation's top few hospitals by US
News and World Report .
About Partners HealthCare System
Partners HealthCare was founded in 1994 by Massachusetts General Hospital and
Brigham and Women's Hospital. Partners is an integrated health care system that
offers patients a continuum of coordinated high-quality care. The system includes
the two founding academic medical centers, community hospitals, specialty facilities,
community health centers, primary care and specialty physicians and other health-related
entities. Partners HealthCare is a nonprofit organization.
Questions & Answers
Isn't an affiliation actually a merger
of our Hospital with Mass General (MGH)?
As a matter of fact, it is not. There are various types
of business affiliations. A take-over is
when one company or institution takes control of another.
A merger is when two separate entities
join together to become one. An affiliation is
when two separate entities form a stronger relationship
but each retains its autonomy, and that is how Nantucket
Cottage Hospital has joined together with MGH and Partners
HealthCare. All of these hospitals would work together
to derive various benefits that come from being part
of a larger system.
So, have we become a part of a major conglomeration like the banks
and the Electric Company, where we dial a 1-800 number to speak to someone
elsewhere in Massachusetts about our on-island service?
No. NCH retains its own identity and will continue
business as usual. When individuals call the Hospital,
they reach one of our Front Desk receptionists or the
nurses' station, just as always has been the case.
The goal of the affiliation with Partners and the MGH
is not to change the Hospital so that it fits into
some sort of corporate standardized model, but rather
to support individual hospitals and caregivers so we
can deliver the highest quality care and services to
patients in the most appropriate way in our own community.
But why wouldn't MGH take more
control over our Hospital?
Partners HealthCare understands that the NCH knows
our community best and that we need to maintain the
kind of autonomy and flexibility necessary to preserve
the special relationship with our community. The
sense of community will be preserved and protected.
Then exactly what does the affiliation mean to
The affiliation builds on and expands the various
collaborations that already exist between the MGH
and NCH. For instance, the MGH might help us obtain
vital coverage in such clinical areas as emergency
services. It may also provide an expanded pool of
consulting specialists to our physicians.
But hasn't our Hospital always had affiliations with Boston teaching
Yes, however, this is a more formal partnership than
the collaborations NCH has with other Boston hospitals.
Also, there are additional direct and indirect financial
benefits as a result of the affiliation.
What is the financial benefit for NCH?
Because NCH has become part of a robust, financially
sound organization that is one of the strongest health
care systems in the nation, it is a direct benefit
to our hospital. Under the terms of the affiliation,
the MGH and Partners agreed to contribute $5 million
to NCH to help it address its specific capital needs.
Additionally, there is the possibility that we could
borrow money for capital projects and other needs
at a much more favorable rate than we could independently.
And what's the benefit for MGH?
There is a financial aspect to the affiliation that
could benefit hospitals throughout the state. Affiliating
with the MGH will enable NCH to seek a change in
its designation from “critical access” hospital to
“rural” hospital. (Several years ago NCH converted
from “rural” to “critical access” to provide us with
slightly more favorable Medicare reimbursement
rate.) If this change back to rural status occurs,
it would provide a financial benefit for all hospitals
in Massachusetts because the state's Medicare reimbursement
rate would increase, and MGH and other Partners facilities
would be among the many hospitals in the state that
could realize greater reimbursements.
But then what will happen to NCH's Medicare reimbursements if we change
our designation back to “rural?”
While a switch back to rural hospital status would
decrease the Medicare reimbursement to the Hospital,
the affiliation agreements between the MGH and NCH
ensure that the MGH and Partners would provide the
funds that would make us whole. It's a win-win for
all hospitals in Massachusetts to make such a switch.
Will patients notice any differences under this affiliation?
They won’t. Patients will continue to receive high
quality care at NCH or any of the other Hospitals
to which our physicians are currently referring their
Are island patients who consult with specialists from other hospitals
pressured to switch physicians and move their care to MGH?
No. All pre-existing clinical relationships or referral
patterns that are established and have been working
well will not be disrupted, and patients will not
be limited by their choice of consultants. The affiliation's
aim is to enhance the continuity of care between
our community hospital and its physicians and the
specialty services a patient may need at an academic
medical center. The MGH will work closely with NCH
to determine where gaps in care or specific clinical
needs may exist and then determine appropriate opportunities
to expand, reinforce or add specific services to
Will the affiliation end fundraising for NCH?
No. When it comes to quality healthcare, particularly
for an island community that is accessible only by
boat or plane, there is always a need for additional
cutting edge equipment and professional development
that help to ensure enhanced medical services. NCH
continues to rely upon the generosity of our donors
to provide the financial support that allows this
to happen. An important element of the Affiliation
Agreement and one of the items that makes this an
affiliation and not a merger is that all funds raised
here, on island, will remain here for the benefit
of our Hospital. So, all of our fund raising activities
will remain just as critical to the continued success
of the Hospital in the future, as they do now.