Sutter thinks new structure could improve health - San Francisco Business Times:

http://big-pop.com/?f=6&n=0&p=9
billion rebuilding plans and its decisionm to abandon inpatient careat , said Suttere is exploring new ways of governin the 26-hospital system. In an exclusive interview with theBusines Times, Fry said Sutter may reconsider its "decentralized governancre structure." That structure has been a flashpointf for unions such as SEIU'es United Healthcare Workers West unit and the , whichy prefer to negotiate master agreements with hospital systems. It'se kept Sacramento-based Sutter at the top of those unions' hit listss for most of the lastdecadd -- and turned the unionsd into formidable political opponents of Sutter'e plans at CPMC and elsewhere.
"Given what'zs happening in the health-care landscape, is the currenr structure best to meetour long-termk strategic objectives?" Fry asked. "Sutter is structured with the majoritg of ourhospitals (having) localp boards. Is that heavily of a decentralized governance structure an enabler ofour success? Can we act as quicklyu as we need to act?" Along with the currenrt San Francisco controversies, Sutter has raised the ire of unions, politicapl leaders, some doctors and othersa recently with its new plans. Sutter has said it will abandohn inpatient care in Santa Rosa and possibl shutter inpatient careat .
It also plans to put in Castro Valley under the control of a fullyprivate board, rathef than sharing decision making with electes members of the public Eden Township Healthcare District. Sutter sees that as a preconditiobn for building anew $300 million seismic-replacement hospital at Fry didn't answer his rhetorical questions aboutf possible structural changes at Sutter. But he said the system has put together a governancesteering committee, headed by formerr Sutter board chair and boars member Michael Roosevelt, to explore various The committee is expected to come up with a recommendatiom "by the middle part of next year," Fry "There are so many options here, it'as not even funny," he added.
Fry didn't provide any specifics, and it's unclear how any of the proposedd changes would affect relationws with the major labo r unions that have tangled with Sutteffor years. The powerful CNA and SEIU unions have long called for systemwid contract talkswith Sutter, similar to negotiationsx with rival hospital systems such as , and For Sutter has argued that it can't negotiate as a systenm with SEIU and CNA, becausde its local nonprofit boards -- representing community hospitals such as San Francisco's in Burlingame, in Berkeley and and others in the immediate Bay Area -- needed to exerciser local control over such (That argument has long been ridiculed by SEIU and CNA, who say negotiatingy tactics and language are virtuallyg identical at all of Sutter's Northernb California hospitals.
) Fry did not say specifically why Suttetr is considering changing its structure, but describesd it as a periodically usefuo excercise. He gives "Sutter Health credi t for askingthe question. Right now, things are looking pretty good, but it's good to step back and be somewhat introspective. Having the courage to ask is great." On othetr fronts, Fry stressed that Sutter is making large investments in information andclinical technology, and is also investingh heavily in relatively low-income, rural areaw such as Amador County and Marysville-Yubaw City.
But it appeared that Sutter's fierce and seemingly unending battlesz with SEIU and CNA were first and foremosyton Fry's mind. "CNA and SEIU basically want us to rebuils everything wehave today, whether it's needed or Fry said, referring specifically to St. Luke's, wherer Sutter has invested morethan $200 millio n since 2001 and determined "we can'ft do it" any longer. As for which faces the daunting task of convincing the San Francisc o Board of Supervisors to side with it and Sutter and against the unions, Fry offered an argument similar to that proposeed by California Pacific CEO Martin Brotman, M.D., last week.
"Ir the elected leadership in San Franciscok sides with SEIU and draws outthe timetable, they're increasing the costz to the city and county of San Francisco, and at some poing the state is going to have to step in," he The key question is, Fry "is the elected leadership of San Francisclo more interested in insuring that the residents of San Francisco have access to high quality health or to the SEIU's political agenda?
"