Officials were confident about their plans Thursday, but it was unclear how the new hospital would be paid for or who would run it. The University of Maryland Medical System estimates that building the hospital and integrating it into the network would cost $600 million.
For years, many Prince George’s residents have gone elsewhere for medical care and hospitalization — often the District and Anne Arundel and Montgomery counties — to avoid the troubled, county-owned system now managed by Dimensions Healthcare. Also, many doctors concerned about the system’s viability have been reluctant to set up shop in the county — leading to a shortage of doctors.
There are about 80,000 uninsured residents in the county, which has a population of about 863,000. The rate is far higher than that of neighboring communities, according to a Rand report commissioned in 2008 by the County Council.
The deal is in the early stages, but Gov. Martin O’Malley (D) insisted that it will lead to the establishment of a sophisticated medical system in Prince George’s, where poor management and political infighting, as well as a shortage of paying patients, have led to a financially weakened Dimensions. The nonprofit medical group operates Prince George’s Hospital Center in Cheverly and facilities in Bowie and Laurel.
“This is an announcement to transform the hospital so that it is a place of choice for the residents of Prince George’s County to go there for their health-care needs,” O’Malley said at a news conference in Upper Marlboro. “It’s not just a promise; it’s actually a process that involves everybody laying their assets on the table and figuring out how we finance this and get to the next level.”
County Executive Rushern L. Baker III (D), who campaigned on a commitment to fix the county’s health-care system, was similarly upbeat.
“This is a big deal for us,” he said. “Having an academic medical system like UMMS is exciting. It will add instant credibility to a system that has struggled to sustain itself.”
Efforts to improve medical care in the county have foundered in recent years, but a changed political climate in Prince George’s appears to have helped bring about Thursday’s agreement.
“The biggest difference now is that everybody is pulling together,” said former state senator Francis X. Kelly (D-Baltimore County), a member of the state medical system’s board. Even in a tough economy, Kelly said, “we think it is doable” because the political forces are aligned.
Since last year’s election, Baker and the County Council, led by Chairman Ingrid Turner (D-Bowie), have been considering ways to improve health care and have been working in tandem on the hospital deal.
Although Prince George’s officials have suggested for several years that the university medical system should come to the county, medical system officials have privately expressed reservations about the reliability of the county’s political and financial support. The university medical system is affiliated with 12 hospitals, the state medical school and a teaching hospital in Baltimore.
In 2007, a $329 million, eight-year agreement to share with the state operating costs and hospital renovations in Prince George’s fell apart. Former county executive Jack B. Johnson (D) backed it, but the then-council chairman, Camille Exum (D-Seat Pleasant), caught many elected officials by surprise when she told the General Assembly that the council did not think the county could afford the arrangement.
But the need for a fix remained. The Rand report painted a gloomy picture of health-care needs in the county. It found that there are enough hospital beds — Prince George’s Hospital Center alone has 265 — but pointed to a lack of specialists in surgery, obstetrics and pediatrics.
It also found there was excessive use by residents of hospital emergency departments, often a place of last resort for patients without easy access to basic medical care. Officials have said the high cost of emergency room treatment and a lack of insured patients contributed to problems with Dimensions’ bottom line.
Lt. Gov. Anthony G. Brown (D), who, along with Baker and O’Malley, shepherded the proposal, personally experienced the shortage of doctors willing to practice in Prince George’s. When his wife was pregnant 17 years ago, he recalled that the couple spoke to their obstetrician about having their baby in the county.
“If you want your daughter to be born in Prince George’s, you will need to find another doctor,” Brown said the doctor told them.
The plan unveiled Thursday calls for continued public financing of Dimensions for the next few years. The company receives $30 million in annual state and county support. The university medical system has said it won’t take on any of Dimensions’ debt, which stands at about $200 million, including pension liability.
The deal must go through several stages and requires agreement among several parties. First, consultants have been hired to study the current medical system in the county to determine the size of the new facility and how it would coordinate care with Dimensions. Also, officials would need to analyze financing and agree on who would pay for different parts of the deal.
The parties would then need to select a site and an actual design and submit a request to the state for permission to build. Groundbreaking is scheduled for 2014, and the hospital is expected to open by 2017. Along the way, Dimensions would be folded into the network, and a new management structure could be installed.
Katherine Harris, one of the Rand report’s authors, called the overall proposal “a good sign.”
“It sounds like they are really making an effort to improve access to primary care and reduce unnecessary hospitalizations,” she said. At the same time, it would permit the network to serve more residents, many of whom will have health insurance for the first time because of the new federal health-care law.