Midcoast-Parkview opposes CMHC surgical center for Topsham

TOPSHAM — Midcoast-Parkview Health is opposing Central Maine Healthcare’s plan to create a $14 million stand-alone outpatient surgical center just 7 miles from its own outpatient surgery department.

“There is no need for the project. We are here,” said Lois Skillings, president of Midcoast-Parkview.

Lewiston-based CMHC in May proposed a 20,000-square-foot surgical center on Topsham Fair Mall Road in Topsham, near its Care Center and Maine Urgent Care. The facility would have two operating rooms and four procedure rooms and would handle cancer, orthopedics, gastroenterology, urology, ear, nose and throat, and breast issues. Patients would receive routine surgeries and treatments and would return home the same day without being admitted to a hospital.

CMHC believes the surgical center is necessary to expand the range of specialty services in Topsham and to provide “local access to a high quality, low-cost surgical setting,” according to the letter of intent it sent to the state in May. It projects increasing demand for outpatient surgery and procedures in the area.

The proposed center requires Certificate of Need approval from the Maine Department of Health and Human Services. The department will hold a virtual public hearing on the proposal at 10 a.m. on Wednesday.

Midcoast-Parkview, owned by MaineHealth, runs the area’s only hospital, as well as a collection of medical practices, senior living facilities and a home health care agency. Officials there take issue with CMHC’s patient projections and said there aren’t enough Topsham-area patients to go around. They project a CMHC surgical center would cost Midcoast-Parkview $10 million to $15 million per year in lost revenue — money it can’t afford to lose.

“If we were in Portland, if we were in Boston or New York, we would not be having this conversation because a little ambulatory care center would be a drop in the bucket because the population is so large and there is enough to go around,” Skillings said. “But health care is really like the lobster industry: It has to be preserved and protected and right-sized in order to ensure that there is access to care close to home in regions of Maine. What they’re doing in Topsham would be is as if lobstermen in Rockland decided to put 500 traps off Bailey Island.”

Midcoast-Parkview officials said their nonprofit health system will have to recoup its losses, either by raising costs on patients elsewhere or by cutting services. They see the proposed center as a “threat to our mission.”

“Our team here is very resilient and we’ll figure it out, but it will be disruptive. The threat is real,” Skillings said.

CMHC, which is also a nonprofit, said its patient projections are accurate and based on solid data backed by firsthand experience.

“Our providers at Topsham Family Medicine and providers and partners (New England Cancer Specialists, etc.) at the Topsham Care Center say the need exists and is growing,” spokeswoman Kate Carlisle said in an email.

She also noted that Midcoast-Parkview’s outpatient surgical department is attached to its hospital, not free-standing as CMHC’s center would be. She said a standalone center comes with lower costs.

“Providers — including independent docs on the mid-coast — tell us that patients in the community are foregoing needed procedures and surgeries, colonoscopies for example, because they have high deductible insurance and the hospital-based rates are too high,” she said. “We’ve been told that patients believe satisfying the deductible could bankrupt them, so they skip necessary procedures and risk their long-term health.”

Carlisle recognized that the proposed center could be seen as disruptive but added that “as the healthcare landscape continues to evolve, it is imperative that healthcare providers evolve with it.”

“This project is tailored to meet the unmet need in the Topsham community as local providers, including MaineHealth’s Mid Coast Hospital, are not offering a low-cost high quality alternative to costly hospital-based services,” she said.

The virtual public hearing will be held via Zoom. Participants should contact dlrs.con@maine.gov for the meeting link. DHHS will also accept written comments on the proposal through August 21.