Nurses from UNC Health Care and Rex Healthcare know how to work together.

Both hospitals were represented among the more than 7,500 attendees at the American Nurses Credentialing Center’s 2011 National Magnet Conference.

The event was held Oct. 4-6 in Baltimore for hospitals that receive the prestigious Magnet designation, which recognizes the best nursing practices worldwide. Attendees also shared their best practices and discussed new strategies for improving patient care.

Among Triangle hospitals this year, Rex and Duke University Hospital were recognized as redesignated organizations. UNC Hospitals received its initial magnet designation.

WakeMed X-Ray has misrepresented the facts and taken statements out of context.

The UNC Health Care System, including Rex Healthcare, consistently works to provide care to the people of North Carolina who can least afford to pay.  We, along with other health care providers across the state including WakeMed, have sought payments supplemental to Medicaid reimbursement to help us provide this care.  These payments are available to state-government owned or operated facilities under the current Medicaid regulatory structure.

The white paper that WakeMed references in its blog was written by an outside consultant who advised that Rex Healthcare is eligible for the Medicaid supplement because it qualifies as a state-government operated facility, not as a state-owned facility.

Rex Healthcare is a private entity. It is not owned by state government, nor are its employees state employees.

But none of this is important to the thousands of patients we see each year. Wake County citizens don’t care about the legal status or corporate setup of their hospitals – they care about the quality and availability of the care they receive.

We think the quality of care in Wake County is the highest at Rex. Part of that is due to the level of competition we face with the other area hospitals – competing for patients makes us even better. And choice is good for Wake County citizens.

We welcome the competition we face in Wake County. Why doesn’t WakeMed?

As North Carolina’s flagship health institution, part of UNC Health Care’s mission is to provide access to care for all our state’s citizens, regardless of their ability to pay. That’s why UNC Health Care purchased Rex Healthcare more than a decade ago – to expand community access to services and resources in Wake County, one of the fastest growing areas in our state.

The UNC Health Care System, including Rex, provides more than $2 billion in clinical care each year, leading to a combined direct and indirect economic value of more than $5 billion annually. And, they provided more than $300 million in uncompensated care last year alone.

Together, UNC and Rex have greater financial stability, more purchasing power and better access to research funding. This leads to more efficient operations and lower costs for patients. In 2010, the Rex and UNC cost per case was nearly 20 percent lower than key benchmarks.

Because Rex brings the UNC Health Care System more financial stability, the System is better able to support the UNC School of Medicine. This level of support would not be possible without Rex. In a time when state funding for the University has decreased, the School of Medicine was able to expand its campus to Charlotte and Asheville to address our state’s physician shortage and to provide access to care in rural, underserved areas.

Together, UNC and Rex greatly benefit North Carolina as a whole.

After UNC Health Care received WakeMed’s proposal to purchase Rex Healthcare, a Special Committee of the UNC Health Care Board of Directors was charged with reviewing the proposal. As part of their due diligence, the Special Committee wanted public input, so it set up an online portal to allow Wake County citizens to share their thoughts. The vast majority of the people we heard from – 80 percent –did not want to see an end to the UNC/Rex partnership. Below are some of the comments the Special Committee received.

We recently reopened our call for comments about this issue. Please share your thoughts to tell us what you think about the benefits of the partnership between UNC Health Care and Rex Healthcare, or about health care in Wake County in general.

We’ve redacted the names of the people who made the below comments to protect their anonymity. Some of these comments have been shortened for this blog post, as noted by (…).

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“By purchasing Rex Hospital, Bill Atkinson of WakeMed is attempting to obtain more of the healthcare market share in Wake County. WakeMed has launched a media blitz to win over support for this proposal from county residents and the N.C. legislature. Contrary to the WakeMed advertisements, allowing WakeMed to purchase Rex Hospital would be detrimental to healthy competition in Wake County, and would decrease consumer’s options for selecting healthcare. Anyone dissatisfied with WakeMed’s service would be forced to go to Duke Raleigh North, or go outside of the county for care. Consumers want a choice, and WakeMed’s proposal, if it occurs, would substantially decrease the choices for Wake County residents. Mr. Atkinson’s promise to build a psychiatric inpatient care unit IF WakeMed is allowed to purchase Rex Hospital sounds like a bribe directed at the N.C. legislature, as the need for psychiatric care is growing. If Mr. Atkinson is working in the best interest of Wake County residents, why not go ahead and build the psychiatric unit now? Certainly this would help Wake County, and the purchase of Rex Hospital has nothing to do with this idea…”

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“I wanted to suggest to and urge the board to reject WakeMed’s proposal to purchase Rex. I don’t believe this is a good idea for Rex, UNC, or the people of North Carolina, specifically those in Raleigh/Wake County. I understand the budgetary issues that North Carolinians and UNC Healthcare and the University are having and believe that those issues will not be solved by this acquisition…

WakeMed’s CEO Bill Atkinson is costing NC more money by forcing us to consider this proposal and he is acting less like a businessman and more like a child that won’t sit down and discuss anything and hang up on the opponents CEOs. He is known for these kind of attacks and jumps ship before the hospitals run into the ground. It would be a shame for him to take out WakeMed, Rex, And UNC Healthcare once this is over.

While I am not in healthcare except as a lab manager in virology research, I can see and analyze what I read in the news and data sources. Their radio advertisements make no sense because the acquisition of Rex would in fact do the opposite of their claims by creating a single large system that controls most of the Raleigh area as opposed to the current Duke, UNC/Rex, Wakemed system that drives competition and ensures that the Triangle is the best place for research AND Healthcare. Duke and UNC (without Rex) may be the other 2 big names in the area however they control the neighboring counties, not Wake county. In addition, Duke and UNC are academic with large research resources/focus. Rex provides UNC that extra revenue to care for patients to compete with the same focus as Wakemed. Research and academia have lower volumes because of the teaching capacity and provide a lot more experimental/risky procedures to further health and science. If UNC loses Rex, it would have to redirect funds to care for all the procedures that don’t require this extra focus…”

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“This aggressive and irresponsible move on the part of Wake Med is ludicrous! UNC Hospital system has the welfare of all citizens in NC. Wake Med has one goal making up for poor management of physician relationships, management of resources, and ineffective strategies to provide care to their patient population. This type of behavior is distracting everyone from putting their mental and fiscal resources in addressing the health care issues of Wake county and the state in favor of the temper tantrum like behavior of a very egocentric CEO (Atkinson) and a very irresponsible Board at Wake. Wake Med was created and supported to provide care to citizens of Wake county and the hospital was located where it is to make it easier for the underserved to have local access to a hospital and health care. Obviously Mr. Atkinson is unable to continue the long standing mission of Wake Med. Shame on him.”

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“I am against the purchase of REX by Wake Med. I have been an employee of both companies and have watched WakeMed’s care and reputation and the morale of the employees, decline under the leadership of CEO Atkinson.

I believe REX has been doing its fair share of indigent care, but if that is something that needs to be distributed out over all hospitals I think that can be addressed without the chaos of combining the two hospitals.

I also believe that REX can help and is more than willing to help with the mental hospital care, again without having to combine forces with WakeMed.

Duplicating services is not what is happening with keeping REX and WakeMed separate. Offering choices and allowing each hospital to focus on it’s strengths allows for diversity and better coverage for all healthcare needs.

Please do not allow this purchase to go through. It would throw NC health care system in to chaos for several if not many years, during which health care in the triangle would decline and state dollars wasted.”

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“A merger with Wake Med will decrease the competitive nature between the two organizations which results in a decrease in options for the patient. Wake Med, though to a certain degree are other successful companies, tend to decrease staff numbers to take care of higher acuity patients only to increase their profit. This type of leadership would damage the reputation of Rex Hospital. Please speak with the physicians that have been part of the Wake system and obtain their insight but the sale of Rex to Wake Med isn’t a community request, rather it is a political ploy by the current Wake CEO to increase their profits.”

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“I’m a physician who has spent the last 10 years working at WakeMed. I strongly support WakeMed’s mission and am proud of the care we provide to the citizens (insured and uninsured) of Wake County. My experience has been that we provide the lion’s share of indigent care in the county. While I’d like to see that burden equally born by all hospital systems in the county, I don’t think the acquisition of Rex by WakeMed would be positive.

My primary concern is the current WakeMed administration. We currently have inadequate resources to provide the care that we need to deliver. The current administration devotes inadequate resources to the physical and human infrastructure of the institution and consequently I have witnessed a progressive decline in our ability to deliver adequate care. I am concerned that under the current administration we’d see a decline at both Rex and WakeMed and the community would suffer.

The current WakeMed administration focuses more on PR than patient care when there are GLARING deficits of which they are well aware.”

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“I have several concerns with the proposal from WakeMed to purchase Rex Healthcare….

This proposal will require WakeMed to secure something in the neighborhood of $800 million in external financing or partnership commitment. The typical return on this type of funding will be roughly 6% in the current market. This means we will have approximately $50 million per year flowing out of our community to some financiers from Wall Street. This drain from our community is poorly timed – and will continue for many years into the future…

Dr. Atkinson has alienated most of the physician providers in the community. He will not be supported in such a monopolistic environment. This bodes poorly for collaboration on services in the future.

Dr. Atkinson is not supported by the majority of his staff. A planned employee satisfaction survey was scheduled for this month, but has been delayed due to unforseen technical issues. Very fortunate timing.

The rollout of this proposal was a shock to our community and the providers impacted by this proposal. This demonstrates a severe disregard for those most intimately involved. A continued push based on an in-vogue political philosophy is not the best platform for improving health-care services for our community.

As both a resident and healthcare employee, I strongly oppose this proposed purchase…”

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“This happened in Wilmington, NC with the purchase of Cape Fear by New Hanover Regional (Dr Atkinson was involved with that purchase as well). A monopoly by New Hanover was created, for both the local population, and the staff. If you wanted to leave that system it would require extra travel time to Brunswick Hospital, or Pender (which was rented from New Hanover). The medical staff at Rex, and or Wake Med would have to travel to UNC or Duke. More than one option for care will keep the hospitals less comfortable in a positive way, to enlist better customer service, and more important strive to continue to be competitive.”

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“Dear Mr. D Jordan Whichard,

The offer to purchase Rex by Wake Med is made for the wrong reasons and not in the best interest of patient care in the community. I believe Mr. Atkinson is interested in empire building and eliminating competition. The physicians that left Wake Med to join Rex did so to escape working with Atkinson and practice in a friendlier and more supportive environment. Rex did not recruit these doctors. Based on accounts published by the News and Observer, Atkinson was clearly miffed by the physicians leaving. He has a large ego as evidenced by the manner in which he is pursuing the purchase.

Rex is an efficient, well run hospital with caring loyal physicians, nurses and staff. Rex has a strong working relationship with UNC that benefits both parties. It is the preferred hospital in Raleigh. I think a sale to Wake Med would be detrimental to patient care in Wake County.”

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“As a long time full-time employee of Rex AND a long term part-time employee of WakeMed I can say both are very good organizations. However, I seriously question the motives of Dr Atkinson. I believe his motivation is simply spitefulness because of the decisions of some medical practices in Wake County to align with UNC-Rex, particularly a cardiology practice.

If Dr Atkinson truly believes a merged Rex-WakeMed will benefit the citizens of Wake County, then surely he believes that UNC Healthcare should buy WakeMed to consolidate care for patients throughout the Triangle? Of course, that answer would be no, since his purpose is a personal political/power grab.

Rex employees shutter at the thought of this man coming onto our campus and dismembering our fine hospital. The status of the pension plan that many employees including myself have worked many years building is of great concern to us, if Atkinson were to come to power. Please buy him out!”

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“I find the possibility of Wake Med taking over Rex Hospital to be distressing. I have chosen Rex over Wake in the past, as have many family members, because I believe it is a better hospital. I also believe that competition is a good thing in any field.

Mr. Atkinson is acting like a bully and I do not believe he is motivated by a desire to offer the patients and community that Rex serves better services. In my opinion, his goal is to kill off competition and to rule an empire.”