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CoxHealth pens pediatric agreement with BJC division

The deal with St. Louis Children’s Hospital follows similar move by Mercy in March

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After previously working together on plans to grow pediatric care in the Queen City, CoxHealth and Mercy Springfield Communities have reached partnerships without one another.

CoxHealth, the latest to ink an agreement, announced in a May 21 news release that it signed a letter of intent to form a pediatric partnership with St. Louis Children’s Hospital, a division of Barnes-Jewish Hospital parent company BJC HealthCare. The financial terms of the deal were undisclosed, and CoxHealth declined to provide a copy of the letter of intent.

The agreement calls on CoxHealth and SLCH to work together to increase access to local pediatric care, with the support of pediatric specialists at Washington University School of Medicine. SLCH is the teaching hospital for the St. Louis-based university.

“In St. Louis Children’s and Washington University, we are fortunate to have collaborators that are mutually committed to working with us to make Springfield a medical hub for pediatric care,” said Max Buetow, CoxHealth president and CEO, in the release. “Today marks an important step in what will be a thoughtful and intentional process to determine how we can improve and expand access to pediatric care for hundreds of thousands of families in this region.”

CoxHealth’s pediatric partnership envisions the creation of a stand-alone pediatric outpatient center, the enhancement of pediatric and NICU inpatient care, and the recruitment and retainment of pediatric providers. A location for the center has not been determined.

“Details are still in development, but our intent is to find a location that best serves the Springfield community,” CoxHealth officials said via email. “We envision a facility dedicated to multiple outpatient services and specialties and maintaining inpatient care at Cox South.”

CoxHealth declined formal interviews on its new pediatric partnership, though emailed questions from Springfield Business Journal were addressed by health system media representatives.

A BJC spokesperson did not respond to a request for comment by press time. In the release, SLCH President Trish Lollo spoke to the benefits of the partnership with CoxHealth.

“St. Louis Children’s Hospital, Washington University School of Medicine and CoxHealth have a shared mission to provide exceptional health care for our patients and communities,” Lollo said in the release. “We look forward to continued discussions to determine how that could best be accomplished in southwest Missouri.”

The organizations are entering a due-diligence process with a goal of finalizing the agreement by early fall. More details are expected to be shared at that time, CoxHealth officials said.

SLCH, according to its website, has 3,423 employees, 881 physicians and 455 licensed beds. SLCH has comprehensive services in every pediatric medical and surgical specialty, the website states. The release notes that SLCH has been recognized as one of the nation’s top 25 children’s hospitals by U.S. News & World Report for the past 15 years, and SLCH is designated as a Magnet hospital by the American Nurses Credentialing Center’s Magnet Recognition Program. SLCH, officials say, is the only pediatric hospital in Missouri and Illinois that is nationally recognized by the American College of Surgeons as a Level 1 Pediatric Trauma Center, the highest classification of trauma care.

History with BJC
The new agreement is not the first time CoxHealth has worked together with BJC HealthCare.

In 2012, CoxHealth partnered with BJC HealthCare, Saint Luke’s Health System of Kansas City and Memorial Health of Springfield, Illinois, to form BJC Collaborative LLC, according to SBJ archives. BJC and Saint Luke’s recently completed a merger.

The best practices and group purchasing partnership continues today.

In a 10-year report on BJC Collaborative released in 2022, BJC HealthCare officials said the partnership had expanded to include Blessing Health System in Illinois, Sarah Bush Lincoln Health System in Illinois and Southern Illinois Healthcare.

“It has achieved over $617 million in total savings for its members through various initiatives around supply chain, value sourcing and bundled purchasing,” said Chris Watts, BJC HealthCare chief strategy officer and BJC Collaborative executive sponsor, in the 2022 report. “The collaborative’s members have completed two clinical research trials in coordination with Washington University School of Medicine with associated community outreach across Illinois, Missouri and Kansas. The collaborative has consistently built clinical relationships across our markets including virtual services.”

According to the report, the seven BJC Collaborative partner organizations had combined net revenue of $14.1 billion, 46 hospitals, nearly 75,000 employees and a service area population of around 11.3 million as of 2022.

Mercy Springfield Communities, which reached a pediatric agreement in March with Children’s Mercy Kansas City, provided a statement to SBJ that, in part, alludes to BJC Collaborative.

“We wish CoxHealth would have joined us in welcoming the pediatric partner our community clearly voiced was their preference, which is Children’s Mercy Kansas City, the No. 1 children’s hospital in Missouri,” Mercy officials said in the statement. “We understand that CoxHealth’s existing relationships may not have allowed for that, as that became clear several months ago.”

CoxHealth officials said via email that its membership in the BJC Collaborative did not influence its new pediatric partnership.

“It is disappointing to see the misleading claim that CoxHealth was motivated by anything other than what is best for pediatric patients and their families,” CoxHealth officials said. “Our vision from the beginning has been consistent: Our region deserves comprehensive pediatric care.”

Mercy has not indicated plans for a stand-alone hospital through its agreement with Children’s Mercy.

Collaborative work
A spirit of collaboration between CoxHealth and Mercy Springfield Communities preceded the latest announcements.

In May 2023, CoxHealth’s Buetow and David Argueta, then president of Mercy Springfield Communities, joined each other on the stage as the main event during the Springfield Business Development Corp.’s Health Care Outlook event.

“We’re very much attached to the hip when it comes to our missional efforts,” Buetow said at the event last year. “It’s neat when you work in an environment like health care to be able to see your competition is striving for the same goal you are.”

Argueta, now president of Mercy Southwest Missouri, said at the time that Mercy’s and CoxHealth’s strategic plans are “probably going to look pretty similar.”

“At the end of the day, we’re trying to do one thing: serve our community in an exceptional manner,” he said.

That collaboration continued through November 2023, when CoxHealth and Mercy announced plans to partner together on expanding local pediatric care. The health systems issued a request for proposals seeking a full-service pediatric partner for the arrangement. However, in March, Mercy’s agreement with Children’s Mercy Kansas City did not include CoxHealth. Officials with Coxhealth said at the time that they were “surprised” by the move.

“We are greatly disappointed that Mercy made this announcement with minimal notice to us, and to the community,” CoxHealth officials said in a March statement to SBJ. “Unfortunately, Mercy’s unilateral decision to end the collaboration is in direct conflict with the clear results of the mutually agreed upon process.”

Upon the announcement of CoxHealth’s agreement with SLCH this month, Mercy officials said the health system’s “hope is that all pediatric care models focus on keeping kids in Springfield, which is one of the main reasons we decided to welcome Children’s Mercy Kansas City into our community.”

“If the CoxHealth and BJC collaboration will provide enhanced care for our kids, we see that as a positive if pediatric care is close to home for the residents of Springfield,” Mercy officials said in the statement. “At the end of the day, the only thing that matters is enhancing pediatric care for the kids in our community.”

CoxHealth officials said by email that its partnership with SLCH represents consistency in its vision.

“Our region deserves comprehensive pediatric care. We are confident that a joint venture with St. Louis Children’s Hospital is the best solution for our community,” the officials said.

CoxHealth’s partnership with SLCH and Mercy’s with Children’s Mercy Kansas City also reflect a larger competitive landscape.

Like BJC HealthCare, Mercy corporate is also based in St. Louis. The two organizations compete in the St. Louis region and other markets. Mercy, according to its website, has around 45 acute care, critical access and specialty care hospitals and hundreds of physician and outpatient clinics in its four-state region of Missouri, Arkansas, Kansas and Oklahoma. BJC HealthCare has 14 hospitals along with multiple community health locations, according to its website.

In January, BJC and Saint Luke’s Health System of Kansas City completed a merger agreement. Mercy’s local pediatric partner, Children’s Mercy, is also based in Kansas City.

Asked whether collaboration would continue in the future between the two local health systems, Mercy officials said via email that “we will always work alongside CoxHealth to meet the needs of our community.”

Reached by email, CoxHealth officials said, “Collaborations are part of the fabric of our organization, and we would never say never on what the future may hold.”


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