New partnership connects three rural north country hospitals to Crouse Health



Three small north country hospitals — River Hospital, Carthage Area Hospital and Claxton-Hepburn Medical Center — announced they will together partner with Crouse Health in Syracuse.

The affiliation agreement maintains each hospital’s independence in governance, budgeting, labor agreements and will not move or remove any local services.

In a Monday afternoon meeting, the hospitals’ CEOs said they intend for the partnership to provide both increased financial security into the future, and access to specialized services for patients in person and remotely via telemedicine.

“We feel very optimistic about what this means for our patients and our future,” River Hospital CEO Ben Moore III said.

Crouse Health employs 3,300 staff members between two hospitals and 500 licensed beds. Crouse is already affiliated with Northwell Health, the state’s largest health care provider, reaching more than two million people in New York City’s metro area each year.

“We at Crouse feel one of our greatest assets is our culture. It sets the tone for quality care, which drives our finances as well,” Crouse President and CEO Kimberly A. Boynton said. “(We all) are committed to success in our communities, to the health of our communities, to our patients and our employees.”

Discussions began in earnest last spring, though each hospital has been looking for a senior partner for some time in the face of a changing industry landscape, and more recently, the uncertainty surrounding health care legislation.

“Carthage has been on this track since about 2011,” Carthage Area Hospital CEO Richard A. Duvall said. “We’ve had to clean up our shop first before we found the best relationship for all of us.”

Chief Medical Officer at Crouse, Dr. Seth Kronenberg, emphasized the partnership as adding value to the individual hospitals, reducing costs (by, among other things, group purchasing,) and improving hometown care through expanded services and provider access.

“Nobody felt threatened because we’re not trying to move services ... we want to support each other” with physician recruitment, access to capital and a pool of resources, Dr. Kronenberg said.

According to the public announcement, under the affiliation “each institution will continue to operate as an independent, separately licensed community-based hospital ... The affiliations do not represent a merger or acquisition, but instead will allow each institution to strengthen patient services and share best practices and expertise.”

President and CEO Nate Howell said Claxton-Hepburn Medical Center had talked to “every hospital locally and all we considered tertiary” before deliberately entering partnership talks.

Both Mr. Howell and Mr. Moore said the arrangement would have no impact on hospitals’ participation in the North Country Initiative, the Delivery System Reform Incentive Payment program administered by the Fort Drum Regional Health Planning Organization, or their ability to receive attached state funding. According to Dr. Kronenberg, the state has been fully supportive of the move.

The hospital heads cited increased telemedicine for remote-access to specialists and care referral options as a driving force behind the deal.

However, the importance of close-to-home care was stressed when talking about transporting north country patients to Syracuse, an already common practice.

“Physicians will always go for the best clinical option available,” said Mr. Moore when asked if patients will now bypass Samaritan Medical Center in Watertown for Crouse. “Not much will be different, but now we’ll have a partner in Syracuse.”

Samaritan Medical Center was included in early affiliation discussions but decided not to participate, Ms. Boynton said.

Samaritan CEO Thomas Carman said, commenting on the agreement in an email, “In this period of healthcare reform, it has become a trend across the state and nation for small hospitals to affiliate with larger hospitals and health systems, and the North Country is no different. In 2013, for example, Samaritan Medical Center formed an affiliation with Clifton-Fine Hospital in Star Lake.

“(Samaritan) is fortunate to be in a financially stable position, which has allowed us to remain an independent not-for-profit hospital ... Samaritan has always been willing to work collaboratively with any regional provider, and we intend to continue to do so for the good of our community.”

“There’s no mandate to physicians to refer (to Crouse,)” Dr. Kronenberg said. “We’re not looking to cut off flow to Samaritan.”

North country hospitals have long held special relationships with Fort Drum, which Mr. Duvall believes will be enhanced by the affiliation.

“Fort Drum has been supportive ... having to travel for care is a concern and this will reduce that likelihood,” Mr. Duvall said.

He hopes the partnership will allow more highly-trained soldiers with specialized health care needs to come to the base.

The medical staffs of the three northern hospitals have been apprised of the plan, all three administrators said, and have greeted it enthusiastically.

“Governance of each institution will remain local. Hospital boards will have the same power tomorrow that they had yesterday,” Ms. Boynton said. “I’m very impressed by the support each hospital has in its community.”

Jen JacksonComment