Upstate patients needing certain specialty surgeries or treatments often have to drive several hours to a larger facility that offers them.

Greenville Health System hopes to change that.

The multi-campus health care system is currently a public not-for-profit governed by a 12-member volunteer board. By adjusting its model of governance, the hospital system seeks to achieve a larger economy of scale to offer more services and treatments that are not currently available in the Upstate.

Under the new plan, which was approved by a 12-2 majority, GHS will create a multi-regional health care system governed by a newly created private, not-for-profit entity that would provide oversight and strategic planning for the entire system. The new govern-mental entity will lease GHS assets, and each affiliate medical center would be organized as a nonprofit and 501(c)(3)

entity under that umbrella.

FOR BETTERThe Board of Trustees is currently

constrained by restrictions that ban GHS from partnering with groups such as religious institutions or for-profit companies. The changes to the gover-nance system would allow GHS to take on projects that have been put on hold, such as establishing a nurse practitioner school at North Greenville University, or partnering with a for-profit company to provide additional inpatient psychiat-ric care.

Expanding services to keep both patients and doctors in the Upstate is a prime focus of the new changes, according to Dr. Eric Bour, president of GHS’s Simpsonville Medical Campus. For certain subspecialties or particularly rare cases, patients must drive to Emory in Atlanta or Duke in Durham, N.C. By expanding Greenville Health System, the board expects to have a population base large enough to support specialty

services.It’s not just the patients GHS hopes

to keep in the Upstate. When doctors have to go to Charleston or elsewhere for medical school and residency, they often stay where they study. That’s talent the health system hopes to attract and retain here. The proposed regulations and expansion would also make GHS more competitive in a rapidly changing health care environment.

“If we don’t do this expansion, we could potentially lose specialists,” said Bour. “At worst, a Novant [Health system] could take over and remove a lot of services because they’re easier to justify in places like Atlanta or Charlotte.”

Proponents for the changes also say that having more facilities within a system will save significant dollars on large-scale purchases such as medi-cal equipment. It will enable smaller facilities under the GHS umbrella, such as Oconee Medical Campus, to update

In Sickness and in HealthUpstate Divided On Changes To Greenville Health System GovernanceBY EMILY STEVENSONPHOTOS PROVIDED BY GREENVILLE HEALTH SYSTEM

Greenville Memorial Hospital is the flagship facility for the growing Greenville Health System.

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their equipment at a lesser cost, offering better care to patients in those areas.

“It would enable us to develop centers of excellence to bring value and quality,” said Bour.

The hospital system’s assets will still be retained by the GHS Board of Trustees as they currently are. The system will also maintain its status as a safety net hospital, as well as its Level 1 Trauma center and its Level 3 NICU center. The biggest change will be in funding, as GHS seeks to move from a fee-for-service model to a value-based model. The new system would require health care providers to deliver more efficient high-quality care at a more afford-able price.

FOR WORSE Not everyone is excited about

having one mega-health care system serving the bulk of the Upstate. Tom Barilovits, who describes himself as a “concerned taxpayer,” worries that too much regulation of the health industry leads to stagnation in new research

developments. “Health care needs competition,”

says Barilovits. “When has bigger ever been better?”

He compared the health care industry to the cell phone industry. Cell phones were rare 15-20 years ago, and the ones that were around could only

make calls. Now everyone has a mini-computer in their pockets, and Barilovits attributes this explosion of new technology to the relative open market for that sector.

“It’s the same thing in health care,” he says. “The law limits what can come into the market.”

One of the biggest controversies about the changes centers on the Certificate of Need, or CON. The CON is a legal document affirming that any health system acquisitions, expansions, or new facilities are truly necessary. It’s required in some states to maintain a safe balance of supply and demand so that patients aren’t overcharged for services or hospitalized without due cause thanks to a surfeit of providers.

But Tim Barilovits, brother to Tom, worries that the CON will

lead to fewer and fewer independent practices, resulting in large, Soviet-style mega-systems with poor patient care.

“We treat health care like it’s a special thing,” said Tim. “If it’s so precious, why are we leaving it to a big monopoly?

Dr. Eric Bour, president of GHS’s Simpsonville Medical Campus

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