Academic health system in talks to acquire Ascension hospital in Mobile, Alabama

An academic health system is in talks to acquire a 349-bed Mobile, Alabama, hospital from Ascension.

Under the agreement, Ascension Providence Health System, its flagship Ascension Providence Hospital, and affiliated clinics would join Mobile-based University of South Alabama Health Care Authority.

USA Health includes University Hospital in Mobile, a women’s and children’s hospital, a cancer institute and a network of additional locations.

The deal is expected to close in the fall. Plans call for the academic health system to acquire the hospital and its network of outpatient operations. The acquisition is to include the affiliated physician practices of Ascension Medical Group.

In a release on the agreement, Dr. John Marymont, vice president for medical affairs and dean of the Frederick P. Whiddon College of Medicine at the University of South Alabama, said the acquisition will enhance the academic health system’s capabilities and “create jobs and opportunities for more people across a wide spectrum to bolster Mobile and the surrounding area.”

Beyond Mobile, Ascension has a presence in the greater Birmingham area in Alabama. The health system also has a presence in communities along the Gulf Coast.

Data ethics

From page 1 data, Miller called it the “new oil” of today’s digital environment — just as petroleum reserves promised untold wealth in the 1800s in the U.S., the troves of health care data that are being generated are hugely valuable today.

Health care systems and facilities must guard this precious commodity carefully, Miller said, including by understanding how data is collected, used and maintained at their organizations.

Miller’s webinar on May 3 was an installment of “Emerging Topics in Catholic Health Care Ethics.” That webinar series is sponsored by CHA, Georgetown University, Loyola University Chicago and Saint Louis University.

Common good for data use

Miller explained that ethical concerns around data use fall under the category of applied ethics. Some of the ethical principles that come into play have to do with respect for human dignity and considerations around the common good, as captured in the Ethical and Religious Directives for Catholic Health Care Services

Miller noted that numerous organizations have been deliberating and delineating ethical concepts for data use in health care. The Vatican, for instance, issued in February 2020 a Rome Call for AI Ethics. That document puts forth high-level categories for evaluating the use of data, including reliability, transparency, inclusion, impartiality, security and privacy, and responsibility. Miller said the framework from the Vatican can be very useful for ministry organizations and others as they are making decisions around data use.

Miller explained that there are many types of health care data, including structured data, which is specific, quantitative data points; unstructured data, which are clinical notes and other qualitative information; administrative data, which has to do with backend processes like coding and billing; patient-generated data such as that coming from Fitbits and other biometric trackers; population health data; and consumer data.

Revenue stream

During the webinar, Miller elaborated on top areas of concern when it comes to health care data.

He described the great potential to monetize such data and the possible hazards of doing so. Data is a prized commodity because it can help organizations unlock clues to patient and consumer behavior. It can be very lucrative for the organizations that possess such data to sell it. Creating a revenue stream in this way can be of much interest to providers, and especially ones that are operating on tight margins. But, challenged Miller, under what parameters is it OK to fuel economic progress by extracting and selling data from patients? How does such activity either promote or hinder human flourishing?

Miller also described the “myth of big data,” or the potentially false belief that the more data organizations have, the more problems they can solve with the data. Miller asked rhetorically what the purpose is of storing up data and whether data will be used in a way that is an appropriate reflection of who ministry providers are.

Relatedly, he warned of the potential to perpetuate bias through the wrong use of health care data. To illustrate, he laid out a case study in which algorithms a group of data scientists used to process health care usage data for a study were based on false assumptions. As a result, he said vulnerable people were denied appropriate, timely care when the study results were applied to a care access policy.

Privacy and security

Miller noted that while most health care providers are well attuned to the need to

Under what parameters is it OK to fuel economic progress by extracting and selling data from patients? How does such activity either promote or hinder human flourishing?

protect health care data from exposure, there can be a false security when providers give third parties access to deidentified data. That is data that has had patient identification information removed. Miller said that there is much value to companies in connecting disparate data sets in order to draw linkages among the data points included in those sets. Reconnecting data in different sets introduces the potential for third parties to inappropriately “reidentify” patients, Miller cautioned.

In a related topic, Miller said that privacy and security are always in counterbalance to each other. To illustrate this concept, he described how video doorbells can help provide a layer of security for a resident, but potentially can violate the privacy of people passively walking by. When those people are recorded, there is the possibility their privacy could be violated.

Power dynamics

Miller also brought up concerns around informed consent of patients when it comes to the use of their data. There is a history of various types of abuse of the providerpatient relationship and so it is an essentiality in health care that patients are informed about all aspects of their care and that they are told the implications of that care. He related the concept to questions around power dynamics when it comes to individual patients on one hand and large, powerful companies on the other.

He asked to what extent patients can consent to the use of their data, whether they can understand the full implications of the use of their information and whether they really have the power to opt out of their data being used. Miller likened it to the experience of having to accept all the terms of service in a lengthy user agreement when buying a smartphone. Usually, a phone buyer cannot use the phone without agreeing to all the conditions put forth by the phone company.

Green concerns

Miller also flagged the dangers of falling prey to “AI hype,” or the sensationalism around artificial intelligence. He said technology cannot and should not be seen as the end-all solution for problems and by the same token it should not be viewed as an untamable tool.

He also elaborated on concerns around the environmental impact of big data. The generation, processing and storage of data requires the erection of gigantic data centers around the world filled with rooms of servers. Those data servers use copious amounts of energy to run. To what extent do health care providers consider the environmental cost of operating these data centers? Miller wondered.

To close out the webinar, Miller said he’s aware that there is great work already being done by ministry systems and facilities to pay heed to such concerns. He advised that providers continue to work together to stay on top of the considerations.

“We need to ask the questions of ‘why.’ When looking to collect data, we need to ask why and to explore the implications,” he said. “We need to create oversight groups to make sure we’re deploying technology in alignment with our Catholic identity. We need to explore the implications of developing technologies.”

Miller referenced an article he coauthored with others from within the Catholic ministry, “Data Ethics in Catholic Health Systems.” That article is available for purchase at tinyurl.com/5xdmar46. jminda@chausa.org

Mercy Housing

From page 1 to communities with limited resources is of mutual interest between Mercy Housing and Catholic health care. We are exploring how to leverage our core competencies. Mercy Housing excels at building and managing affordable housing as well as developing trusted relationships with people who call Mercy Housing home. Our health care partners excel at providing preventative services, wellness programs and medical services to people in those same communities.

Today we understand that to control health care costs you have to pay attention to what is happening outside the clinical environment. One of the key social determinants of health is stable housing. Both Mercy Housing and Catholic health care providers are looking at the whole person. With the Housing First model that we use, it is important to start with housing stability then address other needs, because issues like financial mobility, mental, physical and emotional wellness, and academic achievement will not improve without housing stability.

What are some challenges that could interfere with partnerships in these areas?

We’re all in a different world because of the pandemic. The devastating disruptions to our health care system partners are well known. Collectively, we are defining a new normal. Many of our existing partners speak of two major challenges — recruiting staff and increased costs of hospital operations.

For Mercy Housing, we are challenged by our mission to increase the inventory of affordable housing through real estate development — which takes years — and the massive increases in construction costs.

Our shared founding communities were driven by mission and strong values. They were called to serve those most in need, to do better. This history allows us to overcome many of the challenges that might exist with other real estate partners.

What types of financing does Mercy Housing use for its properties?

In today’s economic environment, we must be creative. Every deal requires multiple layers of financing to build affordable housing. We’re using federal subsidies and tax credit investments. Many banks are motivated by the Community Reinvestment Act but there can still be a gap in financing. We partner with state, local, and regional partners to bring credits and other resources to Mercy Housing communities. In many cases, philanthropic partners donate financial gifts for capital projects or to pay for resident programs.

Beyond money investments, how else are ministry providers supporting affordable housing expansion?

Mercy Housing enjoys many existing partnerships with Catholic health care partners that began with the gift of land. Hospitals sometimes find they have obsolete buildings or excess land that could be used for affordable housing. These are often uncovered as providers update their health needs assessments and strategic business reviews. Some of our partnerships are complex, reserving some beds for respite care in the new affordable housing that is built with donated land or buildings. In some cases, they provide free wellness and critical medical care to Mercy Housing residents on-site or at a shared facility.

How do those alignments lead to greater partnership in helping vulnerable people?

When Mercy Housing can focus on our core business, housing, and partners focus on their core business, health care, our shared clients, the most vulnerable people, benefit.

Together we can bring services closer to them in a culturally relevant way and in a way that meets them where they live. This approach increases the probability of them taking advantage of preventive programs, keeping them out of emergency rooms and urgent care. Educating and empowering them to drive their wellness journey keeps them in school and on the job. It provides them with the tools to live with dignity and change their life trajectory. which is part of Trinity Health. Mercy Care was expanding its federally qualified health center and Mercy Housing was looking for opportunities to add housing in Chamblee, Georgia. Mercy Care partnered with us and we co-developed affordable housing for seniors adjacent to Mercy Care’s health center.

At the end of the day people who are stably housed are receiving health services that ultimately improve their long-term life outcomes.

And in Vancouver, Washington, PeaceHealth was building a new campus and also saw a need for affordable housing. PeaceHealth had excess land and we weren’t yet in Vancouver. It was a natural partnership. So on that excess land we built our first family housing development in Vancouver. We’re looking to grow and do more with PeaceHealth.

These are just two examples of where we’re increasingly seeing our mutual interests align and seeing mutual benefit. We have common interests. We’re sitting down with existing and new partners asking how we can multiply our impact.

What does partnership between Mercy Housing and Catholic health care providers look like from a practical standpoint?

There is mutual learning between Catholic health care providers and Mercy Housing. For example, Mercy Housing provides permanent supportive housing for people who are homeless. They also are high users of emergency services, which has high costs. As we create permanent supportive housing, we see they also are patients and we ask how they can stay stably housed and healthier.

We look at how to get preventive care to them. Perhaps there’s a case manager in a housing unit. Perhaps there’s transportation we coordinate to medical care. It’s a value-add for the health care provider. Through partnerships between Mercy Housing properties and Catholic health care and senior care, we’re working on how to help manage people’s health care needs day to day and ensure they get care early instead of relying on the emergency room.

What grounds the partnerships between Mercy Housing and Catholic health ministry organizations?

Partnerships have really been part of the Mercy Housing legacy since the beginning. That legacy comes from the fact that we were sponsored by seven communities. The sisters were passionate, fierce and committed to the ministries of housing and health care. They recognized that what these ministries are doing is really hard work and it can’t be done alone. You have to invite others in.

Today, the challenges have evolved, and we must think big on a systems level. The people who are most vulnerable are falling through the cracks of our systems. The need for us to work together is greater than ever.

What are some examples of those partnerships between Mercy Housing and Catholic health organizations?

In Atlanta, there is a strategic partnership we’ve jointly developed with Mercy Care,

With our families living in Mercy Housing sites, we’re learning that they need good nutrition, healthy food and management of chronic conditions so that they don’t lose their employment. They need child care. We’re looking at how we can use the hospitals’ community health needs assessments, how we can partner with hospitals and how we can structure partnerships for the residents of our housing sites. We align with the hospitals around the needs of the community. It’s mutual learning and mutual alignment.

There’s clear understanding on both our parts that there is a need. So now it’s about matchmaking. We’re getting the right people in the room from Mercy Housing and from the Catholic health partner and we’re seeing the magic happen.

Those conversations are happening and it’s exciting because we can take those success stories and scale them across our markets. There’s cross-learning and collaboration.

Visit chausa.org/chw for more examples of partnerships between Mercy Housing and Catholic health care providers. jminda@chausa.org

Retired sisters’ move

From page 1 giving many people or their families pause about moving into eldercare communities.

When the sisters and a group of advisers finished their research and discernment on a new home for the retirees in 2021, they had selected Shakopee. “A higher power might have played a hand there,” says Andy Opsahl, Benedictine vice president of business development.

“We just happened to have a late opening and enough availability.”

A few of the sisters moved to Benedictine St. Gertrude’s and the Gardens, an established facility in Shakopee that has skilled nursing care and assisted living.

‘I love it here’

Opsahl had been in discussions with the congregation’s leaders for about four years before the retired sisters began their move in late summer 2022. The talks began with the possibility of developing an eldercare community with the sisters in Mankato and ended with the relocation of the retirees to Shakopee, a town where some of them years earlier had been assigned to serve at schools and parishes.

The sisters’ housing is mixed in among that of lay residents. Most of the sisters moved into Windermere Way’s independent living section. Sr. Cerella Baumgartner settled into a two-bedroom ground-floor unit with her roommate, Sr. Anne Becker. Like many of the other units the sisters were given, theirs had not been previously occupied.

Even several months after the move, Sr. Baumgartner still marvels at having an apartment that is much more spacious and modern than what she had at the motherhouse. The roommates have their own bedrooms and bathrooms on opposite sides of the unit with a living room, kitchen and glass doors that lead to a small patio in between.

Sr. Baumgartner turned a section of her walk-in closet into an office space with a desk and chair. “I love it here,” she says of her new home.

Staying connected

Sr. Baumgartner spent decades teaching at Catholic schools staffed by the congregation before retiring to the provincial residence. Even there, she was in charge of transportation for a while and tutored children at a learning center the congregation ran.

She doesn’t have official duties at Shakopee but that doesn’t slow her down. She delivers jigsaw puzzles to anyone who wants one and makes the rounds to visit other sisters. “They keep telling me, ‘Cerella, you are going to be 93 now in Octo-