JOHNSON CITY — Mountain States Health Alliance has revoked the privileges of several cardiologists to practice at any MSHA facility after the physicians merged with Wellmont CVA Heart Institute, part of Wellmont Health System — MSHA’s main competition in the region.
Tri-State Cardiology based in Johnson City officially became part of Wellmont CVA Heart Institute in late October. Since then, the Tri-State cardiologists have been banned from MSHA facilities, including Johnson City Medical Center, forcing their patients who use MSHA to either choose another hospital in another community or switch cardiologists.
Tim Belisle, vice president/compliance officer and general counsel with MSHA, said the Johnson City-based health system entered into an exclusive contract with its cardiologists a couple of years ago, which prohibited other cardiology groups from practicing at MSHA facilities. When Tri-State Cardiology joined Wellmont CVA they became part of a group not contracted to practice at MSHA facilities, and as such, Tri-State cardiologists lost their privileges, Belisle said.
Belisle said Tri-State Cardiology actually helped draft the exclusive agreement between MSHA and the cardiologists several years ago.
“They were one of the groups that was most interested in trying to do this because it preserved their business — because competitors — other groups — couldn’t come in and reduce the volume (of patients) that was available to them,” Belisle said.
“They were well aware of all of the terms. Unfortunately there are some patients who may be impacted by it. But it’s based on choices that their physicians made as far as where they wanted to practice. And it’s been very clear to them from the beginning that if they did choose to merge with this other group, that they would not be able to practice at our facilities, and that’s a contract that they signed several years ago,” he added.
Dr. Mark Chang, who was a founder and president of Tri-State Cardiology, said the cardiologists were aware of the preferred services agreement.
“We knew that they had the option to terminate our privileges. We thought there was a chance that they would not exercise the option,” Chang said.
He said that before Tri-State Cardiology officially merged with Wellmont CVA, it received written notice from MSHA.
“We did receive written notice that if we did that, they would exercise that option,” he said.
Since the merger, most of his patients have chosen to continue receiving care through Tri-State Cardiology at its offices in Johnson City, Chang said.
“They’ve all just followed me along to allow me to take care of them wherever I am allowed to take care of them,” he said, noting that Wellmont CVA does not require its physicians to work solely at Wellmont hospitals. Tri-State cardiologists can practice anywhere they want — except at MSHA facilities, he said.
“And from Wellmont’s perspective, they were fine with us continuing our work at MSHA facilities,” Chang said.
When it merged with Wellmont CVA, Tri-State Cardiology included six cardiologists. One of those physicians has since left the practice to join the Veterans Affairs Medical Center.
Tri-State Cardiology was actually in talks to become employed by MSHA before it decided to merge with Wellmont CVA.
Chang said 80 percent to 90 percent of cardiology groups across the country are now working with, employed by, or integrated with hospitals and health care systems to help improve efficiencies and the delivery of care. He said Tri-State Cardiology was looking to do the same thing.
“What we ended up doing was finding a group of cardiologists who are already incredibly well-structured, who have already been practicing a high-quality cardiovascular type of practice similar to what Tri-State was trying to do, that had already integrated with Wellmont Health System, and had an incredible structure in place that we thought met all of these larger goals at multiple levels. And so we thought it would be best for our patients and for us going forward to be a part of that,” Chang said.
Tri-State cardiologists continue to work out of their Johnson City office, and now their services are bolstered by those of Wellmont CVA, which includes 40 cardiologists and surgeons, Chang said.
“This allowed for expansion of the number of physicians and physician services that Tri-State had access to, including areas that Tri-State didn’t provide before. So we felt like it was a great marriage and a great expansion of our ability to provide the highest quality of care to our patients, which had been our mission all along,” Chang said. “The tragedy is — it’s forcing patients to make a choice. It’s putting them in a difficult decision,” he said.
Back at MSHA, Belisle said Tri-State’s merger with Wellmont CVA was “purely a business decision.”
“For whatever reason, they felt like they were better aligned with Wellmont, and they obviously felt like it was worth losing their privileges at Johnson City Medical Center and the other facilities in order to make that alignment happen,” Belisle said.