By Shelia Watson
Contributing Writer

Eyes are on Charleston as discussions of collaboration continue between the VA Medical Center and the Medical University of South Carolina. However, Charleston’s VAMC is not the first to entertain the concept.

The VA facility in Denver entered into discussions with the University of Colorado Hospital in 1999. After several years of negotiations, Denver’s VA health center decided against a fully integrated facility in favor of a stand-alone one.

In April 2006, a Government Accountability Office report entitled “VA Health Care: Experiences in Denver and Charleston Offer Lessons for Future Partnerships with Medical Affiliates” compared negotiations between the VA and UCH with those between the VA and MUSC.

The similarities and distinctions between Charleston and Denver are worth noting.

“Negotiations between VA and UCH on the different joint venture proposals were hampered by a lack of VA leadership buy-in and miscommunication,” the GAO report noted. “In addition, there was miscommunication about the amount of land available for a federal tower and VA’s space requirements. … These events (of miscommunication) contributed to an atmosphere of mistrust between VA and UCH.”

The GAO’s “Preliminary Information on the Joint Venture Proposal for VA’s Charleston Facility,” produced September 2005, reported, “VA and MUSC have collaborated and communicated to a limited extent over the past three years on a proposal for a joint venture medical center. … As a result of the limited collaboration, negotiations over the proposal stalled.”

However, the stall did not evolve into the mistrust Denver experienced. After a congressional delegation’s visit in August 2005, the VA and MUSC began moving negotiations forward, establishing the Collaborative Opportunities Steering Group, which in turn chartered four workgroups to examine critical issues related to the proposal:

• The governance workgroup examined ways of establishing organizational authority within a joint venture between VA and MUSC, including shared medical services.

• The clinical service integration workgroup identified medical services provided by VA and MUSC and opportunities to integrate or share these services.

• The legal workgroup reviewed federal and state authorities (or identified the lack thereof) and legal issues relating to a joint venture with shared medical services.

The finance workgroup provided cost estimates and analyses relating to a joint venture with shared medical services.

The steering group issued its final report to the Under Secretary for Health and to the president of MUSC in December 2005. The report concluded that the most advantageous options were those that would provide a revenue stream for the VA and provide MUSC access to new space without capital financing.

The group explored construction models that incorporated benefits to both organizations that included taking advantage of the VA’s access to capital financing and access to MUSC’s revenue streams.

In the meantime, Denver is pursuing its own facility and is seeking available land on which to build. House bill H.R. 5815 provides $98 million for that facility to purchase the land. No money has yet been provided for construction.

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