By TRACEY DRURY
Business First

State officials want health-care systems to work together.

They want competitors to collaborate.

But that may not happen easily here.

At least not judging by words from the leaders of Western New York's two largest health systems.

"There are still competitors out there, like the Catholic Health System, who want to create another arms race," said James Kaskie, CEO at Kaleida Health.

Told of Kaskie's comment, Catholic Health CEO Joseph McDonald responded: "The positive issue of competition is that the better I am, the better they have to be."

Kaleida and Catholic Health are competing on multiple fronts, including stroke centers and heart/vascular care.

"What they (Catholic Health) are doing is really trying to create a whole other duplicate system, which is what we're trying to reform," Kaskie said.

McDonald responded, "A lot of people in this region don't really appreciate the positive powers of competition, but we also don't want mindless competition."

The chasm between the two is clear, but bridges are being built under the state's watchful eye.

The players recently met at a forum convened by the state Health Department that included 30 hospital leaders from Kaleida and Catholic Health, as well as others from Sheehan Health Network, Erie County Medical Center and representatives from the county health department. Sheila Kee, associate commissioner for the health department's Western Region, said the initial tension between some rivals seemed to dissipate as the meeting went on and a candid conversation began.

"I give everyone in the room an A-plus, a gold star on their forehead," she said. "I think it's a fresh start. They're talking about improving community health in a collaborative way."

But will that collaboration come soon enough to truly reform health care in the region? Kee said it needs to happen soon.

"If you look at our neighborhoods, they are community health war zones. We've got to do something different if we're going to change this," said Kee, who is leading a series of joint community planning sessions. "We're hoping through coordination we can stop service duplication and hopefully improve outcomes."

Kaskie said he would be open to collaborating with Catholic Health but hasn't received positive responses to previous offers.

"The door is always open for collaborative models, but as we've opened the door, no one's crossed the threshold," he said.

McDonald said his organization is open to collaboration, as well. He pointed to arrangements with Roswell Park Cancer Institute and providers outside the region, including Rochester, Cleveland and Atlanta.

"I don't believe everything has to be made in Buffalo for us to bring value to our patients," he said. "There's a lot of discussion of creating services here so people don't have to travel, and there may be some validity to that. But you need to create networking relationships with the best providers in the entire world and figure out how to bring those skills to this market."

Other health-care executives related to both systems say there should be a way to make it happen. Robert Gioia is chairman of Great Lakes Health, a new umbrella corporation created by state mandate that is overseeing Kaleida and ECMC and a planned vascular institute on the medical campus. Gioia said the organization hopes to find a way for Catholic Health to participate in that effort.

"We have a wonderful opportunity with this Global Vascular Institute at creating a model that is unheard of that I would hope the Catholic Health System would see the benefit of collaborating with and how that would improve the ultimate care of their patients," he said.

Mark Sullivan, Catholic Health's chief operating officer, stressed that its own heart/vascular programs are important, too, and shouldn't be discounted just because something new and big is being created.

"Our heart program is very strong - nationally competitive. Those are services where there's an unmet need that we're meeting," he said. "We're giving the families and patients different theaters to practice in."

Sullivan added that the kind of reform called for by the state is well under way within the Catholic system, evidenced by last year's closing of Our Lady of Victory Hospital and subsequent reopening as a long-term care community; and an ongoing merger between Sister's Hospital and St. Joseph Hospital.

Yes, the system is spending millions on capital investments, expansions and renovation - including a $32 million emergency department expansion at Mercy Hospital - but it's misleading to label it as an arms race, he said.

"The health-care agenda for our community," Sullivan said, "cannot be set by one health system alone."