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Reporter's Notebook: A different Metro Health again seeks to do open-heart surgery

BY Sunday, January 17, 2021 12:27pm

At some point in 2021, the Michigan Department of Health and Human Services will make a decision that may very well lead to altering the competitive balance for heart care in West Michigan.

A decade after an unsuccessful bid, Metro Health is again seeking state approval to perform open-heart surgery, creating new competition for the existing programs in the region at Spectrum Health and Mercy Health Muskegon.

In a certificate-of-need (CON) application to the state, Metro Health wrote that its proposal aims to “meet an unmet need” and provide “choice within the market” for adult open-heart surgery and therapeutic cardiac catheterization for “current patients and physicians.”

That’s the same argument that Metro Health made in 2010 when the state denied a request to launch open-heart surgery, citing an inability to meet CON standards in place at the time.

The obvious difference between then and now is Metro Health’s ownership by the University of Michigan Health System, which is known for high quality. Among the latest accolades are Newsweek’s 2020 list of top hospitals in the world, where University of Michigan Health Systems’ Michigan Medicine — the academic medical center in Ann Arbor — ranked best in the state and 15th globally.

U.S. News and World Report also ranked Michigan Medicine 14th in 2020 in an annual list of top hospitals for cardiology and heart surgery.

As the state reviews the application that Metro Health filed in December, health care consultant Mike LaPenna has no doubt it will get the OK to do open-heart surgery.

“They’re going to get it this time, hands down. No problem, I think,” LaPenna, principal of The LaPenna Group Inc. in Grand Rapids, said in a recent conversation we had about Metro Health’s new bid to launch open-heart surgery.

Executives at both Metro Health and University of Michigan Health in Ann Arbor declined to discuss the CON application until after the state rules on the filing. In the application, Metro Health indicated it meets current CON standards to do open-heart surgery and projects to treat 311 cases a year, just above the 300-case threshold required.

More than four years after the acquisition by University of Michigan Health System, the Metro Health of today is a much different health system than the one that tried unsuccessfully to secure state approval a decade ago. Metro Health “is a (University of Michigan) hospital,” with a revamped medical staff structure, LaPenna said.

“This is a totally different organization and the connection with (the university) is the key,” he said. “It’s absolutely not the same hospital.”

Presuming Metro Health meets state requirements and gets approval, the health system has a number of factors on its side to form a successful open-heart program that includes coronary artery bypass surgery and cardiac valve repair.

Among them is geography in suburban Wyoming, where it moved into a new hospital 13 years ago. The location can draw heart patients from western Kent County and from eastern and southern Ottawa County down the M-6 and I-196 corridors, LaPenna said.

Spectrum Health’s Meijer Heart Center on the Butterworth Hospital campus and Mercy Health Muskegon are the two closest hospitals to Metro Health that perform open-heart surgery. Metro Health stands to dilute the market share of both with a competing program, although LaPenna believes it may draw more heart patients that need surgery away from Mercy Health Muskegon than from Spectrum Health, which opposed Metro Health’s 2010 request to the state.

Other regional hospitals that perform open-heart surgery are Spectrum Health Lakeland in St. Joseph, Bronson Methodist Hospital and Ascension Borgess in
Kalamazoo, and in Lansing at Sparrow Hospital and McLaren Greater Lansing.

Metro Health Hospital also sits right in the middle of a growing epicenter and population with a relatively modern facility. The alignment with the University of Michigan will draw patient referrals as well, LaPenna said.

State approval to do open-heart surgery would take Metro Health “to another tier,” he said. Right now, Metro Health has “great heart people out there, but they don’t have the full range of heart options,” requiring heart patients who need surgery to go elsewhere as well as physicians based there losing their patients.

“There’s complementary care that keeps the patient centralized in an area where the community of specialists can cross refer,” LaPenna said.

Performing open-heart surgery can pay dividends beyond attracting more heart patients to Metro Health, LaPenna. Medical specialists and subspecialists when recruited by a hospital tend to consider what clinical programs it provides.

An endocrinologist treating diabetics, for example, will want to keep their patients within the health system if they someday require heart surgery,
LaPenna said. Not having that option available and having to refer those patients elsewhere is “like having a crown with one jewel missing,” he said. 

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