Anne Arundel Medical Center and Johns Hopkins Medicine announced yesterday a strategic alliance, giving the Annapolis hospital a chance to take advantage of Hopkins' cachet and programs and providing Hopkins access to more suburban patients.
The affiliation will mean that Arundel Medical can offer new services and that the two institutions can share the cost of developing satellite medical centers and other initiatives. It also means AMC will send some patients to Hopkins' giant East Baltimore campus for complex treatments.
The two have already begun collaborating, with Hopkins agreeing to provide primary care doctors to staff a new facility Arundel Medical will open early next year on Kent Island.
And the two have started working together on some clinical trials for oncology patients, such as testing a new way of irradiating breast cancer. That gives AMC patients access to experimental treatments without traveling to Baltimore, and provides Hopkins researchers with a larger base of patients.
Hopkins has reached out to the suburbs over the past decade with its large Green Spring Station outpatient center in Lutherville and by buying Howard County General Hospital in Columbia.
The new affiliation is not a merger or acquisition. Both hospitals retain their current management and boards. After a period of rapid-fire mergers and acquisitions in the 1990s, hospitals now are moving to such looser alliances.
"We've gotten past the point where we have to own everything ourselves," said Bonnie L. Phipps, chief executive officer of St. Agnes Healthcare.
"That was a '90s thing. Now, we're willing to share." Her Southwest Baltimore hospital announced two months ago an alliance with St. Joseph Medical Center in Towson.
Anne Arundel Medical Center resisted merger opportunities over the past decade, although it had talks with Hopkins, University of Maryland Medical System, MedStar Health and what was then North Arundel Hospital, now Baltimore Washington Medical Center, said Martin L. Doordan, chief executive officer of AAMC.
Over the past year, Doordan said he had conversations with his old friend Ronald R. Peterson, CEO of Johns Hopkins Health System - both completed the George Washington University graduate school in health administration in the early 1970s and both have been with their respective hospital systems ever since.
Without giving up its independence, Doordan said, AAMC was able to get help to develop facilities in Anne Arundel and nearby counties, where already rapid growth is expected to accelerate with the military base realignment.
With a $300 million expansion on its own five-year-old campus, AAMC would be hard pressed on its own to complete an ambitious plan to open outpatient centers throughout the county and on the other side of the Bay Bridge, he said.
Under the agreement officially signed yesterday, Hopkins and AAMC promised to give each other the right of first refusal on collaborations in Anne Arundel, a big chunk of Prince George's County, and Kent, Queen Anne's, Talbot and Caroline Counties.
The other Anne Arundel County hospital, Baltimore Washington Medical Center in Glen Burnie, also has a big campus expansion in the pipeline as well as off-campus outreach.
Just Wednesday, it announced plans for an outpatient facility near Arundel Mills mall. Baltimore Washington is part of University of Maryland Medical System, which includes hospitals in Easton and Cambridge.
Peterson said Hopkins had decided a few years ago that, "We didn't feel the compelling need to buy more hospitals, but we did have the need to have influence over a broader network."
With more demand for its services than it can meet, Peterson said, Hopkins is looking to "rationalize" the process of deciding who can be cared for in a community hospital and who needs Hopkins' highly specialized services.
Dr. Edward D. Miller, CEO of Johns Hopkins Medicine, said Hopkins could be looking for a few similar alliances. "We always look for affiliations.," he said, although he said no other deals are pending now.
Alwyn Cassil, of the Center for Studying Health System Change, a research outfit in Washington, D.C., said ties between academic medical centers and suburban hospitals have been common in other markets the organization has studied.
Major teaching hospitals, including Cleveland Clinic and Massachusetts General Hospital, are able to assure a flow of patients for complex care, she said, while the other hospitals benefit from "an institution like Hopkins, with its tremendous reputation, giving its imprimatur to a suburban hospital."
Victor Broccolino, the CEO of Howard County General, said his institution had benefited from "the immediate glow of being affiliated with the No. 1 hospital" in 1998 when it was bought by Hopkins. Hopkins also had helped his hospital expand its scope of service, Broccolino said.