Times Record: What’s behind the curtain at DHHS? (Feb. 25, 2013)

So what now, now that Central Maine Healthcare Inc. has pulled its Certificate of Need application to take over management of Parkview Adventist Medical Center?

The truth is, only a dozen or so people know. And even they probably don’t know.

Certainly we don’t. The process by which the state grants its assent to a tie-up between hospitals isn’t the most transparent process in Maine. It’s decided by a three-member panel which has decided, without comment, it hadn’t been given enough information to make a decision.

The state gave no public statement. The only comment was from hospital officials with a stake in the outcome — who said, predictably, that all is well, remain calm.

This application was filed in August 2012. It’s been six months. The fate of employment for more than 1,000 health care workers — and the makeup of our very health care system — hangs in the balance.

We’re on record as opposing the Certificate of Need, but there’s a bigger issue here. What if the state isn’t up to the task?

Certainly the state Department of Health and Human Services has taken the lion’s share of state budget cuts over the past decade. Perhaps there’s not enough staffing left at the Certificate of Need division to get the job done.

Even more plausible: What if CMHC decides this is no longer worth the hassle and goes on its merry way? They have plenty of hospitals to manage, and plenty of the same thorny issues that face all hospitals — from lack of MaineCare reimbursement to Obamacare penalties for re-admissions.

Who knows what numbers would make the Parkview-CMHC partnership palatable to regulators? Because the data are largely shielded, and hideously complex even to those with a bird’s-eye view, the public likely will never get the chance to make its own independent judgment of how well the state is regulating our region’s hospital footprint.

We know the rough outlines of the finances at Parkview, the CMHC conglomerate and Mid Coast Hospital.

That picture leads us to believe the market is speaking. And though it could well lead to a painful outcome — we note hundreds of jobs likely will be lost, whatever is decided — the bottom line is this: The public needs a high-quality hospital system that can be profitably supported by those who pay the bills.

The state has told CMHC officials that, from what it’s seen, a CMHC-Parkview partnership doesn’t meet that standard. Can CMHC now reassure the state — and our readers — that it can?

It is a very open question — one that will not likely be answered this year, and one that’s not helped by a troubling lack of transparency as CMHC and state officials fumble through this process.


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