Is a cardiac program needed in Anne Arundel County?

Shanteé Woodards
Contact Reporterswoodards@capgaznews.com
Which Anne Arundel County hospital should get a cardiac program?

Plans to bring cardiac programs to Anne Arundel County should be denied because they would affect area hospitals' caseload, according to objections filed with the state.

Both Anne Arundel Medical Center and the University of Maryland Baltimore Washington Medical Center have applied to the state for permission to offer open heart surgery. But LifeBridge, Prince George's Hospital Center and MedStar Health — which includes MedStar Union Memorial and MedStar Washington Hospital Center — filed objections to the plans. At the same time, AAMC and BWMC have criticized each other's proposal, claiming one would offer a better service than the other.

"Both applications project that they would divert a number of cardiac surgery cases from other programs in the Baltimore region, including Sinai's program," LifeBridge Health CEO Neil M. Meltzer wrote in a July 23 letter to the Maryland Health Care Commission.

LifeBridge includes Sinai, Northwest and Carroll hospitals, and Levindale Hebrew Geriatric Center and Hospital.

"The applications do not present persuasive evidence that there is a need for an additional cardiac surgery program in the Baltimore region. .. Instead, the applications seek to justify the proposed new programs on the ground of convenience for residents of their service areas and the hospitals' own institutional goals and priorities."

In February, AAMC and BWMC applied to the Maryland Health Care Commission to offer an open-heart surgery program. They had to demonstrate they could offer a program with an annual volume of 200 or more cardiac cases and not impact existing programs.

Officials are expected to either approve one program or deny both. It is unclear when a decision will be made. The objections were filed during the public comment period, which ended July 27. Anne Arundel County Executive Steve Schuh and Health Officer Jinlene Chan also wrote in support of having a cardiac program here, without specifying which facility should offer it.

The hospitals have until next week to file their responses with the state. BWMC spokeswoman Kristin Fleckenstein said the hospital would respond at that time. AAMC officials said they intended to "provide a quality cardiac surgery program to Anne Arundel County residents."

"Having a full range of cardiac services available through one team, at one facility that is located within a safe travel time, will enable AAMC to enhance the health of the people we serve and the individual patient experience." chief strategy officer Paula Widerlite said in an emailed statement.

Over the years, Anne Arundel County's hospital administrators have decried a system where they had to send their most severe cardiac cases to Baltimore or Washington D.C. facilities because they didn't have their own program.

Currently, both hospitals only offer cardiac patients are treated by angioplasty with a stent.

Still, the possibility of a competing program concerned other administrators that had been trying to stop patients from going elsewhere. In Cheverly, Prince George's Hospital Center has "worked hard to reduce the out-migration of county residents for health care services, including cardiac surgery and is having success in this regard," wrote Dimensions Health Corp., doing business as the hospital center.

"(AAMC's) application confirms its desire to siphon patients from the Metropolitan Washington Health Planning Region, including Washington, D.C. and Prince George's County. PGHC's cardiac surgery program will be severely hindered if the commission approves AAMC's application to establish a competing cardiac surgery center intended to draw off one half of the geographical service area of PGHC's existing program."

AAMC proposed a program that would run in partnership with Johns Hopkins Medicine and have 217 adult cardiac patients in fiscal 2017. BWMC's would operate with the University of Maryland Medical System and anticipates 204 cases for fiscal 2017.

In their objections, both AAMC and BWMC accused the other of offering plans that were not cost-effective. BWMC's program would expand the University of Maryland School of Medicine's Division of Cardiac Surgery, while AAMC "provides little information about its existing relationship with JHM (Johns Hopkins Medicine)," BWMC officials said.

"On a comparative basis, UM BWMC proposes a superior cardiac surgery program..The benefits and strengths that AAMC claims will occur as a result of its program, including significant case volume, staffing, clinical research, training and education, are uncertain given that these benefits depend largely on the continuation of a loose affiliation between AAMC and JHM."

However, AAMC officials claimed BWMC would not be able to reach a threshold of 200 patients a year. It has not met minimum requirements of access and cost-effectiveness, AAMC officials argued.

"For adults in BWMC's proposed cardiac surgery service area, more live closer to the University of Maryland Medical Center or AAMC than BWMC," AAMC officials wrote July 27 through attorney Jonathan Montgomery. "Similarly, unlike AAMC, BWMC saves patients and the health care system little or no money. Moreover, the application projects that BWMC's proposed program will not be self-sustaining."

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