L+M Hospital directly employing its emergency room providers

May 2, 2019

New London — Lawrence + Memorial Hospital has moved to directly employ its emergency room providers — physicians, physician’s assistants and advanced practice registered nurses — in a bid to bolster its emergency services.

The providers had been employees of US Acute Care Solutions, an outside group that contracts with hospitals. L+M’s agreement with the group, which also covered providers at L+M’s Pequot Health Center in Groton, expired March 31, L+M officials said.

The new arrangement will take effect June 1 at Westerly Hospital, which L+M owns.

With the contracts expiring, L+M saw an opportunity “to revitalize our emergency services across the system,” said Dr. Craig Mittleman, L+M’s regional director of emergency services. “It’s been L+M’s vision, and Yale’s too, to employ its own emergency staff.”

L+M affiliated with Yale New Haven Health in 2016.

Mittleman said the new arrangement has afforded L+M greater flexibility in staffing its emergency room around the clock. By deploying providers more efficiently, it has been able to increase coverage in the emergency room by some 25 percent, reducing wait times for patients, he said.

Fifty-one full- and part-time providers work in the L+M emergency room and at Pequot Health Center, which have 34 and 16 beds, respectively. About 90 percent of the providers who worked for US Acute Care Solutions elected to stay on when the contract with L+M and Pequot expired, according to Mittleman.

Some form of the previous arrangement had been in place since 2007.

Mittleman said the change also has occasioned a “cultural shift, a reflection of L+M’s commitment to processes that improve access to care.” He said there’s “less of an arm’s-length relationship” between emergency room providers and the rest of the hospital’s staff, and that emergency room physicians “feel more like they are part of the organization.”

Dr. Oliver Mayorga, L+M’s chief medical officer, said that while contractors tend to be good at providing “billing, coding, hiring, firing and recruiting,” there had been “some misalignment of goals” under the previous arrangement.

“Health care is changing,” he said. “Patients are having more complex issues. They’re living longer, and when there aren’t enough support services, many times they’re coming to the emergency room. We needed to bring the focus back to the patients.”

L+M’s emergency room and Pequot Health Center see more than 85,000 patients a year, and Westerly Hospital another 20,000 or more, Mayorga said.