Franklin Square Hospital is using a host of inducements -- includingformer County Executive Habern W. Freeman Jr. -- to win Harford patients and move in on the county hospitals' traditional market.
The Baltimore County-based private hospital's bid for Harford County patients has included contests for schoolchildren, free blood-pressure tests, a new drug- and alcohol-addiction treatment center and a local-call telephone number to its Essex headquarters.
And it is paying off -- one in eight of its inpatients comes fromthe southern part of Harford, statistics show.
"Actually, we didn't pick Harford County; it picked us," said Frances Kelleher, Franklin Square's vice president for marketing. "We looked at the figures and saw that many of our patients were coming from Harford."
Each month, hospitals in the state must send the Health Service Cost ReviewCommission, the state agency that regulates pricing for all hospitals, the ZIP code of every patient it has discharged. Every quarter, the agency makes available to hospitals a breakdown of their business.
By running that data through a computer, a hospital can determine which ZIP codes its patients come from. Franklin Square breaks the numbers down -- the codes that are home to the top 50 percent of its patients make up its primary service area; the codes for the next 25 percent are the secondary service area.
The southern quarter of Harford is in Franklin Square's primary service area, and another two quarters are part of its secondary service area.
One inducement the hospital is using to win over county residents is former County Executive Freeman, now a state senator. He's been hired as a consultant by the hospital.
"I go to talk to business people and industry about what (the hospital has) to offer and the quality of the services theyhave and the types of programs," the District 34 Democrat said.
Though he has been in the promotional role for just five months, Freeman has worked as a physical therapist at Franklin Square's White Marsh clinic for the past three years.
"Now I have the additional responsibilities to promote their facility," he explained. "A couple of people on the board . . . were looking to let Harford County people know what they were offering. I guess they were looking for someone to head up a movement.
"They see Harford County as a place where theyhave some future."
The Joppatowne resident says that several people in his office live in the county. He also says a significant number of the hospital's doctors, nurses and employees live in Harford.
"I believe in them in terms of quality," he said. The hospital is located near Golden Ring Mall, about 15 miles from Bel Air.
Freeman says representing a hospital from outside of the county doesn't bother him. "My concern is that we have in the area an excellent hospital.It's kind of like you get it where you can get it."
Though he sees several reasons why countians are using the Baltimore County hospital, he says the principal one is the quality of the staff.
"I think that they offer a high quality, and I think they have done an excellent job, especially with their baby-delivery work. They're well-known for that. Also, apparently there have been occasions where people have gone to other hospitals in (Harford) and they have been transferred to Franklin Square" to take advantage of more sophisticated equipment, he said.
"I think as long as they (Franklin Square) keep pushing, they'll keep making inroads."
Upper Chesapeake Health System,operator of 275-bed Harford Memorial Hospital, in Havre de Grace, and the 219-bed Fallston General Hospital has taken notice of Franklin Square's presence.
But Upper Chesapeake spokeswoman Darcel Guy views Franklin Square's incursion into the county as a natural development.
"I think that is basically because Harford County is experiencing a tremendous growth," she said. "And most of the people moving into Harford County are from Baltimore County. It's just natural they would go to where they were originally from."
She maintains that more of those recent immigrants will discover Upper Chesapeake's hospitals and turn to them.
"It's just a matter of education," she said."It's just a matter of letting them know we're here."
Upper Chesapeake did not have available a breakdown of its inpatients by ZIP code, but Guy said that the average number of inpatients occupying beds has remained steady.
Frankiln Square's emphasis on inpatient numbers puzzles Guy, she says, when such expensive business is on the decline at hospitals.
She says Franklin Square's rising share of county residents' business doesn't worry Upper Chesapeake. "I don't think we see it as a threat," Guy said. "You just want to make sure you keep the people healthy."
Guy adds that the two Harford hospitals even draw some patients from Baltimore County, much as Franklin Square draws from Harford, though she could not provide specific numbers.
Still, Franklin Square has made serious inroads into the county. The number of admissions from the Joppa-Fallston area increased 23.5 percent from 1986 to 1989, reaching 2,955 patients -- almost 15 percent of the hospital's business.
"With (Interstate) 95, and (U.S.) 1 paralleling it, Franklin Square is easy for people to come to from Harford County," Kelleher said.
"One thing that has helped us . . . is White Marsh Mall. When they come down to White Marsh, they realize we're not that far," she said.
"The other advantage we might have isthat we're a full-service hospital. The primary services are medical, surgical, pediatrics, obstetrics, psychiatric and emergency. If youoffer all of those, you are a full-service hospital." So the hospital has tried, just like Upper Chesapeake, to raise its profile among Harford residents. "Our main switchboard has a number that Harford County residents can dial toll-free," Kelleher said.
She notes that Franklin Square also has created a line specifically for the county that connects to the hospital's nurse-staffed free health information and physician-referral call-in service. "Those are really relatively passive things. . . . We had not expected the public to be as hungry for information."
The real battle for hospital admissions, however,lies not with the patients themselves but with their doctors, who often choose where to perform medical procedure.
"As a hospital, we tend to service independent physicians," Kelleher said. "Lots of physicians who have offices in (Harford) County admit their patients here."
Franklin Square does work to recruit doctors, but Kelleher saysthe advertising is secondary. "It's not so much the enticements. It's the quality of the nurses and testing services" that lead physicians in Harford and elsewhere to pick the hospital. "If a patient is particularly sick, the nurses are important."
Scheduling is another key to winning over doctors. "One thing physicians don't have is time," she says, so Franklin Square tries to work with physicians to arrange schedules as best as possible, which often results in early morning procedures done early in the week.
The results with Harford doctors, Kelleher says, are clear. "For a lot of physicians, we are not closer, but they'll still bring their patients here. In Harford County, we are differentiated not by location but by quality." Nevertheless, Kelleher refuses to say Franklin Square is competing with Harford'shospitals. "It's not like we're out to get anyone else. We're out to serve patients."
Guy concurs. "At this point, it's not like there's a price war," she said. "Your price is predetermined. There's just no need for a war or anything like that."
Cost is one arena where the Harford hospitals hope to win more business, though.
Throughthe use of family-care outpatient centers, Upper Chesapeake is trying to attract more patients at lower fees than would be charged at a hospital.
The clinics do not charge an admission fee, like emergency rooms do, but provide comprehensive outpatient service, Guy says. Patients who do not have health-maintenance organization insurance arecharged only for doctor's fees and materials. Franklin Square has noplans to open similar offices in Harford -- though physicians affiliated with the hospital may do so.
"A few years ago, you didn't seethe family-health centers (in the county)," Guy says. "We try to target the outpatient services. It's just so much more cost-effective."
But Harford Memorial and Fallston General are not simply surrendering the full-service market to Franklin Square. "Upper Chesapeake hasa wide range of health services," Guy said.
"Every good health care system, whether it be Franklin Square or Upper Chesapeake, grows to meet the needs of its patients.