With its Upcoming Acquisition of the Sebastian River Medical Center, Sebastian, FL Steward Health Care Will be Entering the Market with “Guns Blazing.”



According to a SRMC doctor who has his offices across the street from the Indian River Medical Center, who wished to be unnamed, SHC is entering the Indian River County market with “guns blazing.”

Have you noticed how many SRMC treatment facilities have opened across the street from the Indian River Medical Center (IRMC), locating in space that private practitioners have moved from after having been acquired by IRMC?   Will SRMC be further creeping in on the IRMC?

In this regard, did you recently receive the well done SRMC direct mail piece sent presumably to all Indian River County households reporting on its 94,000 sq. ft. expansion project and providing a list of physicians on their medical staff, with photographs and contact information?  One of them is the one who said SHC is entering the market with “guns blazing.”

13 of the 33 physicians have offices or secondary offices in Vero Beach.

Steward Health Care is the largest fully integrated health care services organization and community hospital network in New England. Headquartered in Boston, Steward is one of the five largest employers in Massachusetts with more than 17,000 employees in more than 150 communities.

It is a for-profit entity and since SRMC turns a profit its acquisition is a logical strategic move. It had an operating profit of more than $131 million in 2015, according to the Boston Globe.

SHC is a community-care based care model, meaning it effectively does a for-profit and not-for-profit personal and environmental community needs assessment to find out what health care services are needed and then staffs accordingly, thereby creating efficiency (not having too many oncologists for the needs of the community). Note: The Indian River County Hospital District only did a not-for-profit community needs assessment.

As such it can offer services at a lower cost.

It is an Accountable Care Organization, who’s model of fostering clinical excellence while simultaneously controlling costs depends on its ability to incentivize hospitals, physicians, post-acute care facilities, and other providers involved to form linkages and facilitate coordination of care delivery. By increasing care coordination, ACOs reduce unnecessary medical care and improve health outcomes, reducing utilization of acute care services.


This means its model includes collaboration with other healthcare providers, as well as volunteers service providers to take a holistic approach to health care whereby you treat the “whole” person and not simply symptoms and disease.

In essence, as per the Stewart Health Care website:

  • Your providers will have special access to care managers, wellness coaches, social workers and pharmacists, and all of these resources will work with you to make sure you are receiving the right care at the right time.
  • The providers that you see know what is happening with your health because they communicate with one another.
  • You won’t have the same medical tests done over and over because your results are shared within your health care team — confidentially and securely.

By doing so, people are able to minimize ER visits, once again reducing costs.

Compare this model to a model where a 90 year old woman friend at Regency Park called 911, went to the IRMC ER, was admitted and treated by a hospitalist for three days who had no knowledge of who she was.  IRMC never contacted her cardiologist, her primary care physician or her other specialists so they could come visit her.  She’s hell bent on going to SRMC next time.

So in acquiring SRMC, SHC will presumably be applying the same approach here, “forming linkages” with other providers to keep people out of the hospital.

Meanwhile, the Indian River Medical Center, lost $ 4 million in its first quarter, as reported in Vero Beach 32963, in an article by Michelle Genz on February 2, 2017. In an Insight Editorial in the same issue, former Indian River Hospital District (IRCHD) trustee Dr. Val Zudans pointed out that IRMC’s “days cash on hand (DCOH) is down to 50 and that its loan covenants require 60 DCOH.”

So while Steward Health Care will be creeping in on the IRMC, the Friday, February 23,2017 edition of the Indian River Press Journal had an above the fold headline: “Hospital (IRMC) to get survival plan help.  Leaders agree to hire consultant for advice on restructuring.”

IRCHD Chairwoman Marybeth Cunningham was quoted as saying: “There’s a lot of uncertainty. Now is the time to really look and access the structure of what we have as far as the hospital and the district and make a decision for the long term on what the hospital needs to have.”

In a news release dated February 23, 2017, the IRCHD announced that a Collaborative Committee met on February 22 to, to as Ms. Cunningham was quoted as saying “really look and access the structure of that we have.” The committee is led by IRCHD Trustees Ms. Cunningham and Allen Jones and includes IRMC Board of Directors Wayne Hockmeyer and Gerri Smith, and IRMC Foundation Board Chairman Tony Woodruff to assure “long-term healthcare services to the residents of Indian River County.”  “Our focus is to act in the best interest of the citizens,” said Allen Jones, IRCHD Trustee.  “We are trying to stabilize, and create a unity of purpose, focus and trust.”

The news release went on to say that “the committee agreed on several action items including:

  • Contacting James E. Orlikoff to provide the committee an overview to the changing healthcare environment.  Orlikoff is president of Orlikoff & Associates, Inc., a consulting firm specializing in healthcare governance and leadership, strategy, quality, patient safety, and organizational development.  He is the National Advisor on Governance and Leadership to the American Hospital Association and Health Forum, and is the Senior Consultant to the Center for Healthcare Governance.
  • Begin vetting proposals from various consulting companies.
  • Engaging a consultant.
  • Report status to the Joint Board Meeting by the end of March.”

With the IRMC losing money and having only 50 days cash on hand, who will be paying for Mr. Orlokoff and a consultant’s services?  The Indian River County taxpayers?


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