Allina sees changes in hospital services in Minneapolis, Cambridge and Hastings

Allina Health leaders are confident that a series of difficult hospital consolidations this spring will reorganize the Minneapolis-based health system around what patients want and how insurers pay for care.

The Twin Cities' largest hospital system by patient admissions has halted nonemergency baby deliveries and is scaling back other inpatient services at hospitals in Cambridge and Hastings. Allina also closed the freestanding Phillips Eye Institute in Minneapolis, moving its ophthalmology services to nearby Abbott Northwestern Hospital.

Although the losses are frustrating for some in the communities, the changes will maintain inpatient care at different locations and allow the expansion of wellness and prevention services that keep people healthier and out of hospitals in the first place, said Sara Criger, Allina's senior vice president for operations and acute care.

"Over time, that's become more of our emphasis, which is how to impact health and wellness and have that focus versus just responding to illness and injury," she said.

Scheduled deliveries were moved last month from Cambridge to Mercy Hospital in Coon Rapids, while inpatient mental health care is being moved to Mercy's Fridley campus. The Cambridge hospital is being replaced in 2025 with a campus that will include new emergency and surgery departments as well as expanded outpatient mental health and substance abuse services.

Allina's reforms are part of a broader trend, particularly in the area of obstetrics. Bloomington-based HealthPartners last month moved scheduled deliveries from Olivia Hospital in central Minnesota to its regional hospital in Hutchinson.

Declining birth numbers have made it harder for smaller hospitals to maintain liability insurance and keep their obstetrical staff trained. Several rural Minnesota hospitals have halted the practice, while Mercy and North Memorial's Maple Grove Hospital have seen expectant mothers come from farther distances for deliveries.

M Health Fairview is making broad changes in the Twin Cities, closing the Bethesda long-term acute-care hospital and shutting down all inpatient services but mental health care at St. Joseph's Hospital in St. Paul. Fairview plans to halt that service next month and build a 144-bed adult mental health hospital on the Bethesda campus. A public hearing on that proposal is scheduled Thursday.

Hospitals planned the changes before the financial pressures of the COVID-19 pandemic. Allina reported losing $40 million per week when nonemergency procedures were suspended for two months in spring 2020 when COVID-19 spread in Minnesota. Surgery volumes increased 15% from 2020 to 2021, according to Allina financial reports, allowing the system to recoup some losses.

Allina's changes at Regina Medical Center in Hastings include surrendering its license as a standalone hospital and operating it as a satellite of United Hospital in St. Paul. While United is 20 miles away, many patients were driving there anyway for baby deliveries or more complex services, Criger said.

Putting both hospitals under one license will ease the sharing of medical providers and services, she said, and allow for the transfer of recovering patients to Hastings at times when United is overcrowded.

"With the closure of St. Joe's recently, we're more often finding that we don't have beds," Criger said, adding that transfers will benefit patients during recovery, moving them closer to friends and family.

The switch is modeled after Allina's decision in 2017 to put Unity Hospital in Fridley under Mercy's license — moving baby deliveries to Mercy and inpatient mental health care to Unity. Inpatient volumes increased after the consolidation of the two campuses, which transfer about 75 patients per week between one another.

Public hearings about Allina's changes revealed some discontent, including concern that the loss of core services, such as baby deliveries, could be the death knell to recruiting top doctors. An obstetrics nurse at Regina, identified during the hearing as Bobbi, said she was disappointed Allina didn't try harder to stem declines in baby deliveries with better marketing.

"People going to the clinic didn't even know Regina Hospital delivers babies," she said.

Phillips' doctors opposed their relocation to Abbott, which reduced available operating rooms from 10 to three and caused many eye specialists to take procedures elsewhere. The loss of so much expertise and collaboration to solve complex eye problems was disheartening, the Phillips' doctors wrote in a letter opposing the plan.

Criger said the decision was difficult, but the standalone site wasn't as useful because many eye doctors had moved simpler procedures to their clinics or outpatient surgery centers.

Allina also is planning additions, including a surgery center in Brooklyn Park and a specialty medical center that will open in Lakeville in 2023. The goal is making services accessible without being redundant at all facilities.

"We found it hard to be everything to everybody everywhere ... and do it well," Criger said, "