I’ve been covering the business community in the Tri-Cities for more than 20 years now. I was there when the chairs and CEOs of Bristol Regional Medical Center and Holston Valley sat on a stage and told us about the formation of Wellmont Health System. I was there when Johnson City Medical Center acquired the Columbia/HCA hospitals that together formed the nucleus of Mountain States Health Alliance. I was there, in Nashville, when Wellmont tried (and failed) to convince the state Johnson City needed a stand-alone emergency department built on a hospital-sized plot of land. And I was there April 2, 2015, when the chairs and CEOs of both systems announced they plan to merge by year’s end.
One of those things was, in a very significant way, unlike the others. The joint Wellmont-MSHA news conference of April 2, 2015 was not about any particular “us” versus any particular “them.”
Don’t get me wrong. I love competition. It’s at the heart of good business. It drives excellence. But there are ways competition can drive mediocrity as well. And the Tri-Cities has been a remarkable showplace of that for years.
Nobody has been more competitive in this market than Mountain States and Wellmont. During the public hearing in Nashville for the Certificate of Need that Wellmont sought in Washington County, I watched the respective CEOs of the two systems stay in the same room for three hours without once even acknowledging each other’s presence.
Yet the intense competition between the systems led to a cold war-like spending spree on both sides that grew both systems’ debt while creating a surplus of duplicated services in some areas and a dearth of them in others. Short-term factors based on micro-geographic competition drove both systems to make decisions that were bad for each system on a larger scale and in the long-term. What was good for Norton, or Kingsport, for instance in 2005, may have turned out to be bad for the entire system, and for the entire region, in 2015.
Today, the current CEOs are describing the former environment with terms like, “counter-productive,” and, “almost irrational.”
The idea now is that one system, with an over-arching strategy for improving the healthcare marketplace in the region, will do a better job. The state governments of Tennessee and Virginia, through regulations outlined in respective Certificates of Public Advantage (COPAs) will be charged with ensuring the negative potential effects of a monopoly do not appear.
At the April 2 news conference, I asked the assembled delegation of board chairs, CEOs and doctors at the head table the following question: “In terms of both culture and economic development, in the past Wellmont vs Mountain States has been the poster child for the Sullivan County vs Washington County mindset in this business community. Do you see this merger as a harbinger for a greater regional approach in economic development and do you plan to actively pursue such?”
Barbara Allen, Mountain States Board Chair took the microphone and replied, “Unscripted? Isn’t it nice that we’ve all grown up?”
The room, full of influential Tri-Cities businesspeople, burst into applause.
Yes, Ms. Allen, if we all have indeed grown up, it will be nice.
For years, Washington and Sullivan Counties have been at each other’s throats in economic development, while the rest of the state’s regions have been forming economic development partnerships that have gone after jobs far more effectively than we have as individual counties.
Like Wellmont and Mountain States, we have competed, but we have competed mostly with ourselves, and mostly in ways that may have generated short-term benefits for one community or another, but have cost the entire region in the long run.
Mountain States and Wellmont do not need to be competing with each other to bring down costs, so long as the COPA is well-enough written to protect payers, employers and others with whom the hospitals do business. Mountain States and Wellmont, together, need to be solving the problems that lead to ever-increasing healthcare costs.
Just so, Sullivan and Washington counties (and Bristol, Johnson City and Kingsport) do not need to be competing against each other for what other regions see as loose change. We need to be working together to address the issues that make businesses want to take their jobs and capital investment to other areas of the state instead of coming anywhere in the Tri-Cities.
We’ve seen the beginning of such co-opetition this year. Sullivan County and Hawkins County are beginning to work together. Washington, Carter and Unicoi Counties are exploring how to work for mutual economic development benefit. And most excitingly, NETWORKS Sullivan County and the Washington County Economic Development Council have made their first joint proposals.
The support for a regional approach to problem solving in Northeast Tennessee and Southwest Virginia has not been greater since the founding of Tri-Cities Regional Airport. This kind of opportunity may not come again in our lifetimes. But if there is to be further progress, the same grown-ups who are backing the Wellmont-Mountain States merger will need to step forward again.