Strategic alliance vs. acquisition

A hospice which has successfully developed a symbiotic relationship with the dominant hospital in its service area while remaining free to work with other outlying hospitals is Bartholomew County Area Hospice in Columbus, IN. The hospice serves a census of 240 patients in a sprawling, largely rural service area, with three branch sites and a central office located on the campus of Columbus Regional Hospital.

"We are not hospital-based, but loosely affiliated," explains hospice CEO Sandra Carmichael, BSN. "We decided not to be acquired but to form a strategic alliance with the hospital." After a year working with a consultant and discussing the pros and cons of tighter organizational bonds, the two partners jointly decided to walk away from the question of ownership because it was unnecessary. "We’re pleased with the opportunity to put our creative hats on and talk about how we can move forward together, without worrying about who owns whom," Carmichael explains. In fact, if the relationship were any closer, it might impinge on the hospice’s ability to collaborate with other smaller hospitals in nearby communities.

The hospice’s relationship with the hospital runs the gamut from mundane items such as receiving copies of departmental memos all the way up to designating a hospice staff person full-time to participate in the development of the hospital’s new management information system — with the idea that the hospice could tap into it as well.

"They’re now looking at their continuum of care. We’re part of those discussions. We’re part of the cancer center’s product line. I’m part of the hospital ethics committee. I feel it is my place to make sure hospice continues to be part of those discussions. I have the opportunity; I just need to take it," Carmichael says.

"I hope I’m not being naive. We have no intention of going away or changing what we do. I also think we have something to offer. We’re not as independent as when we started. But I don’t see that as changing our basic independence."