NCH Board of Trustees Signs Affiliation Agreement with Mass General Hospital

Effective March 1st and following a comprehensive due diligence process, the Nantucket Cottage Hospital Board of Trustees voted to  affiliate with Massachusetts General Hospital and Partners HealthCare, Inc.
Under the affiliation, patients of NCH will continue to receive high-quality care from the providers they know and trust at the hospital they have long relied upon. NCH will remain as a separate entity with its own Board of Trustees, identity, endowment, cultures and fundraising responsibilities.

Mass General Staff
Doctors and nurses from Mass General Hospital on-island to assist in the hospital's annual Health Fair.

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.
These 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 hospitals.
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 NCH?
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 hospitals?
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 patients.
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 enhance care.
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.

Nantucket Cottage Hospital is an affiliate of Massachusetts General Hospital and a member of Partners HealthCare.