The recent proposal to create an integrated Blair County-wide health system - which one local doctor said could help prevent local hospitals from being "swallowed up" by a mega-system - won't discourage at least one of those mega-systems from trying.
Geisinger Health System would be interested in a partnership with hospitals in Blair County even if a local merger takes place, said Chief Operating Officer Frank Trembulak.
Altoona Regional Health System - which wants to affiliate with Nason Hospital to form a countywide system - didn't comment.
An official for Nason also didn't return a call.
According to Trembulak, patients in areas served by community hospitals fear loss of services when there's merger talk.
They assume that "a big fish" will "draw all the patients out," he said.
History of Geisinger mergers and acquisitions
1981 - Merges with Nanticoke, Pittston and Wyoming Valley hospitals, which becomes Geisinger Wyoming Valley
1998 - Merges with Penn State Hershey to create Penn State-Geisinger Health System
2000 - Geisinger and Penn State undo merger
2005 - Acquires Mercy Health Partners of Wilkes-Barre, which becomes Geisinger South Wilkes-Barre
January 2012 - Acquires Shamokin Area Community Hospital, which becomes Geisinger-Shamokin Area Community Hospital
February 2012 - Acquires Community Medical Center in Scranton, which becomes Geisinger-Community Medical Center
July 2012 - Acquires Bloomsburg Hospital, which becomes Geisinger-Bloomsburg Hospital
They're right, in the case of big academic institutions, he said, which typically bring high-end cases to their main campuses.
"But that's not our approach," Trembulak said.
Geisinger tries to provide care close to patients' homes, provided there's enough demand to justify the needed investment, according to Trembulak.
By affiliating with Geisinger, community hospitals can add to their slate of care offerings, he said.
Geisinger-affiliated hospitals retain "some measure" of independence, he said.
Many community hospitals realize they are no longer sustainable as stand-alones and know they're headed for financial distress if they continue to do business as before, he said.
They'll do better if they look at options for affiliating before they are in distress, he said.
Then they can afford to be selective and will have the leverage to craft a good arrangement with a potential partner, he said.
Creating a countywide health system may not stave off a partnership with a big outside system forever, according to Dr. Jeffrey Rosch, a local doctor concerned about local hospitals being swallowed up.
But the more institutional power and services and the more patients that a Blair County hospital brings to negotiations with an outside partner, the better it will be for local people, he said.
"The more we can represent the entire area as a unit, rather than as disconnected, unrelated pieces, I think that gives us more ability to control the future," Rosch said.
He doesn't know whether Geisinger would be a better fit than, for example, UPMC, Penn State Milton S. Hershey Medical Center or Highmark - the insurance giant that recently got into hospital operations, he said.
"My preference is whatever is going to be best for the citizens of Blair and surrounding counties," he said.
But he likes Trembulak's main selling point.
"I would certainly prefer that services could not only be kept locally, but expanded," he said.
The health care situation is "exceedingly fast-changing," he said. He hopes the local hospitals can be organized enough "to if not withstand the onslaught ... at least to better negotiate the outcome."
UPMC operates the former Bedford Memorial Hospital in this area, but didn't comment on Geisinger's interest in Blair County.
Likewise, UPMC Bedford didn't comment when asked how its big-city affiliation has worked out.