IN-DEPTH
The collaboration effort between Mercy Springfield Communities and Children's Mercy Kansas City (CMKC) to enhance pediatric care in southwest Missouri is moving at a fast pace, and the Kansas City-based hospital will begin seeing patients in southwest Missouri within the coming months.
“We expect to have patients being seen (in Springfield) this calendar year,” Dr. Rob Steele, executive vice president and chief strategy and innovation officer at CMKC, said in an May 29 interview on Mercy's Springfield campus. “We're itchy because we're still in the midst of recruiting, but you know, optimistically, this is within the next couple months.”
The collaboration between the two hospital systems will not be a joint venture, nor a profit-sharing model, said John Myers, president of Mercy Springfield Communities. Instead, CMKC will pay Mercy to lease space within Mercy's existing facilities, but CMKC will operate independently and without oversight from Mercy. The physicians and staff of the new Springfield pediatric practice will be exclusively employed by CMKC.
The model the two systems are aiming for is called a “hospital in a hospital,” but that type of operation still has to be approved by regulators, Myers said. The amount of square feet that CMKC will lease and the cost is still being hashed out, but it will be a significant quantity of space.
“Think of it as Mercy Springfield as the vessel for Children's Mercy to enter the market, using space in the walls of our hospital,” Myers said. “But we're just acting as a place for them to operate out of.”
“We need to make sure everything is regulatory compliant (and) they've got the appropriate space. But after that, it's Children's Mercy running the show when it comes to to pediatric specialty and hospital-based care,” Myers said.
CMKC and Mercy Springfield are moving with speed
The majority of CMKC services will be provided at Mercy Children's Hospital Springfield, located at 1235 E. Cherokee St. Some minor construction will likely be needed to renovate the space CMKC will occupy, Myers said. The Kansas City-based hospital plans to have its own pediatric specialty clinic at a location to be determined in Springfield.
With the pediatric collaboration announced two months ago, Mercy and CMKC are focused on moving quickly to put some specialist pediatric care in Springfield by the end of the 2024 calendar year and use that as a base to build other phases of bringing specialists to southwest Missouri. CMKC leaders have made several visits to see Mercy's facilities in Springfield, with more planned in the future.
The Mercy-CMKC collaboration announcement in March was the first time the Springfield community heard that Mercy and CoxHealth were not going ahead on a partnership to bring advanced pediatric care to southwest Missouri. When the now-defunct plan was announced in late 2023, Springfield city government leaders hailed the Mercy and CoxHealth collaboration as the start of a new era of unprecedented health care cooperation.
Months after Mercy's announcement, CoxHealth announced its intent to form a joint venture with St. Louis Children's Hospital to broaden pediatric care in the Springfield region in May 2024. While details of the joint venture are still being deliberated, the two hospital systems hope to sign a formal agreement by early fall 2024.
St. Louis Children's Hospital is staffed exclusively by the Washington University School of Medicine. BJC HealthCare owns both Barnes-Jewish Hospital and St. Louis Children's.
Recruiting the pediatric specialists that Springfield lacks
CMKC's central focus is to increase the sustainable capabilities of pediatric specialties, said Steele, who practiced medicine in Springfield for 17 years. For a program to be successful, Children's Mercy Kansas City will need to hire about 2.5 specialists for every area of specialty practice, with some requiring more physicians than that.
“It's more than getting a specialist, it's getting multiple specialists and having them as part of a team that can be sustainable,” Steele said. “We're full-on recruitment and we've had some early successes and then we've also had some early challenges.”
General surgery, pulmonology, and endocrine specialists for pediatrics, among others, are immediately needed in Springfield, said Marie Moore, chief nursing officer at Mercy Springfield Communities.
“What they've spoken about is the investment in the community and wanting to build that sustainable infrastructure in the southwest region,” Moore said. “I anticipate that we'll probably see some scaling of that as we bring the services, as the volume grows.”
Recruiting specialists will come in phases in order of needs in Springfield, said Dr. Stacy Doyle, senior vice president, ambulatory and physician practice operations at CMKC. The first phase is focused on seven specialties at the moment, and the next phase will have an additional three or four specialties. There will be more phases down the road.
One of CMKC's first focuses is recruiting surgical services specialists, and the organization needs about 2.5 physicians for that role, Doyle said. CMKC is focused on recruiting specialists who aren't in Springfield at this time.
“We want to work with the specialties that are already here in the community so we are coming independent of Mercy,” Doyle said. “We want to honor what's going on here and add to that, not compete with that.”
CMKC's large network of specialists is helping with recruiting
CMKC is in the middle of drawing up contracts for specialists, and the hospital has several physicians who are waiting to sign a contract, Doyle said. The fact that CMKC will be operating independently in Springfield means those physicians will join a CMKC network of more than 750 pediatric specialists on medical staff, according to the Children's Mercy Kansas City website.
The opportunity to join a large children's care-focused hospital system has helped the recruitment process, but CMKC is still running into a competitive job environment for pediatric specialists, said Dr. Mary Ann Queen, vice president of regional and diagnostic services. The specialists will live in Springfield and CMKC expects to have a leadership team working in southwest Missouri.
“Most of the pediatric specialists out there have lots of options right now,” Queen said. “We're trying to put together the best packages to make it definitely be part of the Springfield community, but they have a connection to their peers that might be in Kansas City.”
The large network behind CMKC will also help keep kids in Springfield for treatment, Steele said. Even if a child has to travel for surgery, having a broad base of pediatric specialties in Springfield will mean that child can go through all the stages of post-op care closer to home.
“Our intention is to have specialists here that are living in Springfield and seeing kids where we can use our own resources from Kansas City to supplement that,” Steele said. “But the intention and the goal is to keep kids here in Springfield.”
36% of southwest Missouri children leave for hospital care
There's a dire need for children's hospital services in southwest Missouri, Steele said.
“Our last evaluation showed about 36% of all children that needed to be hospitalized left southwest Missouri to be hospitalized,” Steele said. “I mean, that's over a third of kids.”
The only way to decrease the number of families needing to seek care in larger cities is to bring in specialists who can treat children in Springfield, Steele said.
“We want to be able to take care of those kids where they live, play, go to school,” Steele said. “We don't want to be shipping them out of Springfield, which is what is happening now.”
CMKC aims to put down roots at a rapid pace
The collaboration between Children's Mercy Kansas City and Mercy Springfield has allowed CMKC to infiltrate Springfield at a much faster pace than if the organization had come at it alone, Steele said.
“We are super excited to partner with Mercy Springfield because they’ve been able to give us a space that we could actually operate,” Steele said. “We couldn’t do it without that.”
The Kansas City-based hospital plans to have its own pediatric specialty clinic at a location to be determined in Springfield, Myers said. When it comes to the space CMKC will take up on Mercy's campus, it will come down to taking over areas that Mercy is currently using for its pediatric services.
“We have all these services operating today” like the pediatric intensive care unit, the pediatric medical surgery unit and more, said Myers. CMKC will be “utilizing pediatric space that we have today already in operation.”
Standalone southwest Missouri children's hospital in the future?
The original CoxHealth and Mercy pediatric collaboration effort included tentative plans for a standalone children's hospital in southwest Missouri. Just as the collaboration effort died earlier in 2024, the dream of the once-promised standalone pediatric hospital appeared to die with it.
When Mercy announced its pediatric collaboration with CMKC, there were no plans mentioned for a new-construction hospital.
CoxHealth's joint venture with St. Louis Children's Hospital (SLCH) will likely include a “standalone pediatric care center,” according to a company press release. It is unclear if CoxHealth and SLCH intend to fund construction of a new building somewhere in Springfield or if the partners plan to retrofit an existing building to make it into a care center.
CMKC's decision not to construct a new children's hospital was made with the intention of getting pediatric specialists on the ground as fast as possible, Steele said. A new hospital would take at least four years to construct. By leasing existing Mercy space for pediatric services, CMKC will be able to get specialists working in southwest Missouri in months instead of years.
Steele said he hasn't given up hope on a new, freestanding southwest Missouri children's hospital at some point later down the line, but it's all about what can be accomplished when resources are split among two major competing hospital systems — Mercy and CoxHealth.
“I think that southwest Missouri deserves a free-standing children's hospital,” Steele said. “It's big enough. It has the right volume and more than a third of the kids that need inpatient care leave southwest Missouri. It's horrible.”
“For all those reasons, I think, yea, southwest Missouri deserves a free-standing children's hospital. It's just whether you can make a go of it when the community is split.”
