8 December 2023IN MY OPINIONBenefits of Partnering with Community HospitalsBy Al Torres, Medical Director, NemoursBuilding partnerships with community hospitals is a business model utilized by tertiary and quaternary hospitals to create a referral base and grow service lines. I will share my personal experience and perspective with this business model as a physician leader at a children's hospital.I joined Nemours Children's Health, Florida (NCH-FL) in 2012 prior to the opening of their new, free-standing children's hospital in Orlando, Florida. I helped recruit many of the 80 physicians present on opening day, October 22, 2012. Being the third children's hospital in the Orlando metro area, we had to invest a considerable amount of time and effort to build hospital patient volumes and a referral base.Prior to opening day, our strategic planning and business development division met with community hospital leaders to build partnerships. We essentially offered our physicians and/or advanced practice providers to see patients at their local hospital to elevate the quality of newborn, neonatal, and/or pediatric inpatient care to keep as many infants and children as possible in their community hospital. Our first signed partnership was in 2013. Our inpatient average daily census (ADC) was 22 and our neonatal intensive care unit (NICU) ADC was 1.7 at that time. Over the next ten years, we built nine more partnerships throughout Central Florida. In 2022, our inpatient ADC had grown to 74.7 and our NICU ADC had grown to 16.5. Although the average case mix index (CMI) for all the inpatients grew from 1.56 to 2.03 from 2014 to 2022, the average CMI for the patients referred from the partnership hospitals grew from 1.95 to 3.33 over the same timeframe. Not having an obstetrical service line in the children's hospital, the NICU at NCH-FL relies entirely on transfers from community hospitals. In fact, 84 percent of neonates admitted to the NICU are referred from our community hospital partners. As important as it has been to our growth as a new children's hospital, it has also increased the patient volumes and acuity of the patients admitted at our community hospital partners. For example, patients requiring supportive care for respiratory infections are no longer being transferred to the children's hospital when this level of care is provided locally. As experience is Al Torres
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