Columbia has always been a medical mecca. The health care industry is a dominant player in the local economy, employing more people than any other sector. The city is home to the second-most hospital beds per capita in the country.

And as the old song goes, the times they are a-changin’. A flurry of mergers, expansions and new affiliations in the past few years has put a new face on Columbia’s health care industry. For those keeping score, here’s a look at recent changes in the local health care business.

“Health care today requires collaboration across multiple hospitals and clinics, medical specialists and geographic boundaries.” — MU Health Care CEO Mitch Wasden


“Any industry that is under competitive and financial strain will always see consolidations and partnerships as a result,” says University of Missouri Health Care CEO Mitch Wasden. “This trend will only increase but will eventually reach a steady state in the next three to five years when many of the changes from the Affordable Care Act have worked through the industry.”

The area’s largest health system, University of Missouri Health Care, has formed a plethora of partnerships, networks and other affiliations as it further expands its reach throughout Missouri and beyond.

► In March 2014, Ellis Fischel Cancer Center joined the MD Anderson Cancer Network, an affiliation of 14 certified provider hospitals in 10 states. The network provides expertise to members, ranging from quality assurance and specialty disease programs to full clinical integration. The Houston-based University of Texas MD Anderson Cancer Center is one of the nation’s leading cancer centers.

► Within the Show-Me State, MU Health Care has formed The Health Network of Missouri, a collaborative regional system of six providers. Other members include Bothwell Regional Health Center in Sedalia, Capital Region Medical Center in Jefferson City, Hannibal Regional Healthcare System, Lake Regional Health System in Osage Beach and Saint Francis Healthcare System in Cape Girardeau. The group accounts for more than 1,000 hospital beds, more than 10,700 employees and approximately 1,200 affiliated physicians.

► A larger, multistate health care network formed when MU Health Care joined forces with St. Louis-based Mercy and St. Joseph-based Mosaic Life Care to create MPact Health. The scope of MPact serves patients in urban and rural areas of Missouri and surrounding states with more than 5,600 hospital beds, more than 47,000 employees and approximately 3,000 employed and affiliated physicians. Network members aim to expand telemedicine to underserved areas, create a database for analytical research and evidence-based medicine, and explore the development of a clinically integrated network of employed, independent and private practice physicians.

► Last fall, Columbia Surgical Associates affiliated with the University of Missouri Health System, forming a separate corporation. CSA physicians — specialists in general, bariatric, vascular, colorectal and breast cancer surgery — perform many surgical procedures at Boone Hospital Center but now have privileges as well at University Hospital, MU Women’s and Children’s Hospital and other MU Health Care facilities. The affiliates tout increased efficiency, medical school opportunities and expanded use of electronic medical records technology as assets in the new arrangement.

► MU Women’s and Children’s Hospital has affiliated with BJC’s St. Louis Children’s Hospital, the oldest pediatric hospital west of the Mississippi River. SLCH’s parent company, BJC HealthCare, also operates Boone Hospital Center in Columbia.

► In perhaps its most controversial move, MU Health Care partnered last year with Nueterra, a health care management company based in Leawood, Kan., to purchase Callaway Community Hospital in Fulton. The minority ownership arrangement (about 35 percent) known as Fulton Medical Center LLC allows MU Health Care to continue operating its University Physicians-Callaway Physicians clinic near the Fulton hospital, as it has since 1974. In February, Fulton Medical Center announced plans to build a 10-bed surgical hospital in south Columbia. Boone Hospital Center opposes the proposed hospital as a duplication of services already provided in Columbia by the four existing hospital systems.

► The health system opened South Providence Medical Park earlier this year. The newly constructed facility on Southampton Drive brought 250 employees from other MU Health Care locations to staff it; MU Health Care officials expect more than 100,000 patient visits to the medical park this year. The building was designed to accommodate future growth, as planners anticipate the need for outpatient services to increase in the future.

► A June groundbreaking opened construction on a $40 million, four-story expansion of the Missouri Orthopaedic Institute. The expansion, set for completion by 2017, will increase clinical space for surgical, inpatient, outpatient and physical therapy services by about 86,000 square feet. The fourth floor of the new addition will be dedicated space for research. The 34 physicians at the Orthopaedic Institute specialize in sports medicine, joint replacement and pediatrics, as well as hip and knee, foot and ankle, shoulder, hand, spine, oncology and trauma care.

► A collaboration with Cox Health and Mercy has the go-ahead for a University of Missouri School of Medicine Clinical Campus in Springfield and a master of occupational therapy degree program at Missouri State University.

► The retirement of Hal Williamson, executive vice chancellor for health affairs at the University of Missouri, has sparked a reorganization of the health system’s administration. A clinical management committee of the MU Health Care CEO and the deans of the medical, nursing and health professions schools will operate the health care system.

“This is not just the evolution of health care but a systematic, conscious approach to altering the financial incentives and the burden of risk relative to keeping people healthy.” — Boone Hospital President Jim Sinek

“Given the direction the health care industry is moving, you will see significant integration between health care providers,” says Boone Hospital Center President Jim Sinek. “Providers are now being incentivized to better coordinate care for patients across the entire spectrum of health and, in fact, are penalized financially for less than optimal clinical outcomes, low patient satisfaction and inefficient care.”

County-owned Boone Hospital has been expanding its brand in its service area. The hospital, operated by St. Louis-based BJC HealthCare through a lease agreement with the county, serves a 26-county area in mid-Missouri. BJC offers additional access to a growing network of health providers, including 14 hospitals, and is pursuing other collaborations and affiliations.

“The providers who will be successful,” Sinek says, “will be those who welcome integration, partnerships and development of clinical and financial systems and structure to manage the quality and cost of health care in a fundamentally different way than ever before.”

► A new medical complex under construction in south Columbia will give new exposure to Boone Hospital. Phase 1 of Boone Hospital South Campus, located at the corner of Nifong and Forum boulevards, is scheduled for completion in late 2015. The 80,000-square-foot building was designed to reflect the architectural features of the main Boone Hospital campus on William Street. The 14-acre site has the potential to house four buildings with a total of 132,000 square feet of space for health care services.

► In January, all health care practices affiliated with Boone Hospital Center were consolidated under a new brand, Boone Medical Group. The BMG brand offers increased awareness of the practices and leverages the familiarity of the Boone Hospital Center name. There are three Boone Medical Group practices in Columbia, plus a convenient care clinic and a specialty clinic for diabetes and endocrinology. Additional mid-Missouri BMG practices are located in Ashland, Boonville, Centralia and Mexico.

► The Missouri Heart Center, a part of Boone Hospital Center, opened a cardiology clinic in Macon in February. The Macon clinic offers a full range of cardiovascular testing capability, including cardiac and vascular ultrasound, ambulatory rhythm monitoring such as Holter and event monitors, implantable cardiac device rhythm management for pacemaker and defibrillator care, nuclear medicine imaging and stress testing. Nine of Missouri Heart Center’s cardiologists provide full-time cardiology services out of the Macon clinic.

► Boone Hospital Center has formed affiliations with three community hospitals in rural Missouri: Fitzgibbon Hospital in Marshall, Samaritan Hospital in Macon and Pershing Memorial Hospital in Brookfield. The affiliation affords these health care providers the ability to coordinate care for patients who move back and forth between their respective facilities, Sinek says, providing a higher quality clinical outcome and experience for patients and their family members while improving the process for providers and support teams. “Boone Hospital Center strives to support the local hospitals and providers to keep care local,” Sinek says. “If a patient can receive quality care closer to home with support from Boone Hospital Center, it is a win-win.”

It’s a new era for health care, Sinek says. One that “puts the patient at the forefront, where they belong, and requires health care providers to work collaboratively with each other to keep patients healthy and out of the hospital. The need going forward will be focused on helping specific populations stay healthy through wellness, education, screenings and, when appropriate, outpatient services.”

The search for quality and efficiency does not stop at Columbia’s hospital properties. Last November, Urology Associates of Central Missouri merged with Missouri Cancer Associates in a move to deliver more integrated, coordinated care in an independent setting.

The move gave Urology Associates affiliation with The US Oncology Network, a nationwide network of 1,000 independent community-based cancer physicians spanning medical and radiation oncology, surgery and urology.

“This union consolidates resources and talents to overcome the challenges today’s health care environment presents,” says Practice Director Debbie Barnes. “It allows us to remain an independent and physician-led practice.”

Urology Associates has also formed an affiliation with Epoch Men’s Health.