Don’t change rules to allow third heart center in Midlands

A STATE HEALTH panel should reject Lexington Medical Center’s request to alter rules so it can establish an open-heart surgery center that isn’t needed.

The hospital, which has repeatedly — and rightly — been turned away in its attempt to open a third heart center in the Midlands, has filed a proposal with the Department of Health and Environmental Control to amend the state health plan. But it would be a mistake to change the plan to grant the wish of one hospital, a wish that isn’t in the best interest of Midlands patients.

In 2004, DHEC made that clear when it denied Lexington Medical’s request to be allowed to open a center. DHEC officials said the center would be duplicative and dilute surgical talent. Centers at Providence Hospital and Palmetto Health Richland adequately serve the area. (We opposed Palmetto Health’s bid to build the second Midlands center a couple of years earlier, for the same reasons.) Last month, an administrative law judge rejected Lexington’s appeal of DHEC’s decision.

Last legislative session, the hospital came up short in its attempt to get lawmakers to grant it a special favor. The House and Senate approved an exception that would have changed the rules to allow Lexington Medical to establish an open-heart surgery center. Fortunately, Gov. Mark Sanford vetoed the legislation, and lawmakers sustained the veto. That legislation would have undermined DHEC’s authority and dismantled the process that helps control quality, duplication and costs in medical care. It also would have encouraged other hospitals to request special exceptions for expensive new programs, whether they were needed or not.

Lexington Medical’s attempt to change the state health plan will be considered beginning the first week in December. That’s when a committee of health-care professionals and laypeople will hold public hearings to discuss possible changes to the plan.

Lexington Medical wants the state to establish a minimum threshold for open-heart surgeries performed each year for a hospital’s entire program. Now, each heart unit at a hospital needs to perform 350 open-heart surgeries annually. A hospital can have more than one unit. For example, Providence Hospital has four. Lexington wants the rules to be changed so each hospital’s heart program, regardless of the number of units, would only have to perform a minimum of 350 each year.

Lexington hopes the lower threshold will help it convince the state that Providence and Palmetto Richland are surpassing the required number of surgeries to operate an open-heart program, and that Lexington’s proposed center wouldn’t cause a drop-off in quality. But hospitals are performing fewer heart surgeries because of improvements in technology and medicine; it’s imperative that heart centers perform enough procedures to remain proficient. Last year, Palmetto Richland, which has two heart units, performed a total of 410 surgeries. A third heart center could take away cases and push that number below 350.

Lexington also wants to make it easier for regulators to grant waivers to account for health-care needs when there are no other open-heart surgery programs in the county; the proposed facility offers catheterization services; the hospital has more than 300 beds; and the hospital has more than 65,000 emergency-room visits.

The state health panel must deny these changes. There is more than enough capacity to meet Midlands heart patients’ needs. Changing the rules would create a crowded market, hurt quality and duplicate services.