Could EVMS merge with ODU, Sentara? A private study is looking at options.

Private parties began exploring potential integrations of Eastern Virginia Medical School with Old Dominion University and Sentara Healthcare about 10 months before telling top leaders of the medical school.

Shortly after EVMS was informed, a consultant was hired to study the academic institution’s programs and finances. Its task will be to provide recommendations to Gov. Ralph Northam on new ways the schools and hospital system could combine.

Northam, who announced the project Aug. 5, said the results may lead to significant changes for Hampton Roads' “health care ecosystem,” which serves more than 1 million people.

“This is an important effort to benefit Hampton Roads, and the Commonwealth as a whole,” Northam, a pediatric neurologist and EVMS graduate, said then.

The consultant, Manatt Health Strategies, is expected to deliver a report Nov. 15, ahead of the General Assembly session in January. Its advice could lead to new legislation or budget amendments for lawmakers to consider that seek to make the medical school more financially stable.

None of the parties has talked publicly about what each hopes the report will say.

Since the announcement, the process has been held behind closed doors. After requests made to EVMS and the state under the Freedom of Information Act, both provided a copy of the contract to The Virginian-Pilot.

The document was not initially provided by either, in part because the agreement was between Manatt and ReInvent Hampton Roads — not the schools or state. ReInvent is a private think tank focused on economic development in the region.

ReInvent chairman John “Dubby” Wynne, former CEO of Landmark Communications Inc., wouldn’t say how his organization got involved or what its role in the process has been.

“Even that is confidential, to be honest with you,” he said.

Officials from the medical school and Old Dominion declined interviews for this story, both citing concerns about the study not yet being complete. But correspondence and other documents obtained by The Pilot revealed the recommendations could mean big changes for the schools as they try to attract more money and faculty.

Though combining EVMS and Old Dominion has been discussed in the region for several years, the new effort to investigate potential restructuring apparently began without the medical school’s input.

Dr. Richard V. Homan, president and provost of EVMS, said Wynne called him July 17 to tell him about the Manatt engagement and process. It was then he learned of the idea, he said in an email to Manatt representatives in August.

“Neither the Board nor I had any knowledge of the Manatt engagement and nor of the previous meetings with Manatt and other parties which occurred over the past 10 months,” he said.

Virginia Secretary of Finance Aubrey Layne said he heard about the study proposal shortly before the governor’s August announcement because it was an initiative that came out of the “business community.”

Regardless of when each of the entities was made aware of the consultant, they all agreed to participate.

Though it’s not clear how the process began and who the major players were, the contract with ReInvent, indicates Sentara is paying for most of it. The $285,000 fee will be covered jointly by the parties, with $185,000 from the private health system and $25,000 each from ReInvent, EVMS, ODU and the state.

Layne said he receives progress reports on the project but is not a participant.

“One of the things the governor is going to look at is what’s in the best interest of the citizens,” he said. “I think that’s the reason why he agreed to be supportive, without dictating the result of this study.”

Virginia officials hope better partnerships could lead to improved health for the people of Hampton Roads. Eastern Virginia lags behind the state and nation in infant mortality, cancer, heart disease and diabetes. Most of these poor rankings reflect disparities with minority and low-income populations.

For instance, the infant death rate in Virginia and the United States was 5.8 out of 1,000 live births in 2017. But in Norfolk, the rate of Black baby deaths was 18.2.

Regarding prostate cancer, the national death rate was 19.5 out of 100,000 lives in 2015. But in Portsmouth, Black men died at a rate of 66.5 out of 100,000 — nearly four times that of white men in the city.

The schools and health system each have their own interests as well as some overlapping goals for integration, according to the contract:

EVMS seeks a new model as a means to get more capital and improve its academic reputation.

Sentara wants to better “align” EVMS' medical group with its own.

Old Dominion wants to expand its health sciences and professional training programs.

And all of them see opportunities to capture more clinical research funding.

Emails between Morris Foster, Old Dominion vice president of research, and Manatt indicated they were also looking for ways to incorporate Norfolk State University in the mix. Study participants suggested that Norfolk State’s nursing, health care administration and social work programs could be areas to find collaboration.

At a virtual town hall meeting Aug. 6, Homan said the school could end up taking on a more “academic health center model.”

EVMS is rare in that it is one of the few medical schools in the country unattached to a university hospital and larger educational system. Because of that, it maintains intricate relationships with Sentara, Children’s Hospital of The King’s Daughters and medical practices throughout the region.

Sentara increased its funding to EVMS in 2018 from $9 million to $26 million a year. For nearly 50 years, the company and medical school have partnered, with faculty and students working in its hospitals, including Sentara Norfolk General Hospital, a level 1 trauma center.

But this quasi-private standing has made it difficult for the school to secure state and federal money. Its National Institutes of Health funding rank was 132, behind other Virginia centers.

The challenge has become apparent during this public health crisis. Dr. Kurt Stauder, CEO of EVMS Medical Group, said the practice, like others, has taken a hit from unexpected costs and a loss of patient volume.

The group, composed of 150 physician-teachers and 40 other health professionals, supports the medical school and treats over 1,600 patients a day. Hazard pay for employees who can’t do their jobs from home wasn’t in the budget, he said at an August town hall meeting, because the practice didn’t qualify for COVID-19 emergency aid.

“We’ve really been looking at how do we keep our medical group sustainable without the federal assistance that others have been afforded,” he said.

Manatt is expected to lay out the costs over the next five years for each party to make any proposed transformation.

Elisha Sauers, elisha.sauers@pilotonline.com, 757-222-3864

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