1. U
pstate patients needing certain
specialty surgeries or treatments
often have to drive several hours
to a larger facility that offers them.
Greenville Health System hopes to change
that.
The multi-campus health care
system is currently a public not-for-
profit governed by a 12-member
volunteer board. By adjusting its model
of governance, the hospital system seeks
to achieve a larger economy of scale
to offer more services and treatments
that are not currently available in the
Upstate.
Under the new plan, which was
approved by a 12-2 majority, GHS
will create a multi-regional health care
system governed by a newly created
private, not-for-profit entity that would
provide oversight and strategic planning
for the entire system.The new govern-
mental entity will lease GHS assets, and
each affiliate medical center would be
organized as a nonprofit and 501(c)(3)
entity under that umbrella.
FOR BETTER
The Board of Trustees is currently
constrained by restrictions that ban
GHS from partnering with groups such
as religious institutions or for-profit
companies.The changes to the gover-
nance system would allow GHS to take
on projects that have been put on hold,
such as establishing a nurse practitioner
school at North Greenville University,
or partnering with a for-profit company
to provide additional inpatient psychiat-
ric care.
Expanding services to keep both
patients and doctors in the Upstate
is a prime focus of the new changes,
according to Dr. Eric Bour, president of
GHS’s Simpsonville Medical Campus.
For certain subspecialties or particularly
rare cases, patients must drive to Emory
in Atlanta or Duke in Durham, N.C. By
expanding Greenville Health System,
the board expects to have a population
base large enough to support specialty
services.
It’s not just the patients GHS hopes
to keep in the Upstate.When doctors
have to go to Charleston or elsewhere
for medical school and residency, they
often stay where they study.That’s talent
the health system hopes to attract and
retain here.The proposed regulations
and expansion would also make GHS
more competitive in a rapidly changing
health care environment.
“If we don’t do this expansion, we
could potentially lose specialists,” said
Bour.“At worst, a Novant [Health
system] could take over and remove
a lot of services because they’re easier
to justify in places like Atlanta or
Charlotte.”
Proponents for the changes also
say that having more facilities within
a system will save significant dollars
on large-scale purchases such as medi-
cal equipment. It will enable smaller
facilities under the GHS umbrella, such
as Oconee Medical Campus, to update
In Sickness
and in Health
Upstate Divided On Changes To
Greenville Health System Governance
BY EMILY STEVENSON
PHOTOS PROVIDED BY GREENVILLE HEALTH SYSTEM
Greenville Memorial Hospital is the flagship facility
for the growing Greenville Health System.
18 GREENVILLE BUSINESS MAGAZINE | JANUARY 2016

2. their equipment at a lesser cost,
offering better care to patients in
those areas.
“It would enable us to develop
centers of excellence to bring value
and quality,” said Bour.
The hospital system’s assets will
still be retained by the GHS Board
of Trustees as they currently are.The
system will also maintain its status
as a safety net hospital, as well as its
Level 1 Trauma center and its Level
3 NICU center.The biggest change
will be in funding, as GHS seeks to
move from a fee-for-service model
to a value-based model.The new
system would require health care
providers to deliver more efficient
high-quality care at a more afford-
able price.
FOR WORSE
Not everyone is excited about
having one mega-health care system
serving the bulk of the Upstate.Tom
Barilovits, who describes himself as a
“concerned taxpayer,” worries that too
much regulation of the health industry
leads to stagnation in new research
developments.
“Health care needs competition,”
says Barilovits.“When has bigger ever
been better?”
He compared the health care
industry to the cell phone industry. Cell
phones were rare 15-20 years ago, and
the ones that were around could only
make calls. Now everyone has a
mini-computer in their pockets, and
Barilovits attributes this explosion
of new technology to the relative
open market for that sector.
“It’s the same thing in health
care,” he says.“The law limits what
can come into the market.”
One of the biggest controversies
about the changes centers on the
Certificate of Need, or CON.The
CON is a legal document affirming
that any health system acquisitions,
expansions, or new facilities are
truly necessary. It’s required in some
states to maintain a safe balance of
supply and demand so that patients
aren’t overcharged for services or
hospitalized without due cause
thanks to a surfeit of providers.
But Tim Barilovits, brother to
Tom, worries that the CON will
lead to fewer and fewer independent
practices, resulting in large, Soviet-style
mega-systems with poor patient care.
“We treat health care like it’s a
special thing,” said Tim.“If it’s so
precious, why are we leaving it to a big
monopoly?
Dr. Eric Bour, president of GHS’s
Simpsonville Medical Campus
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JANUARY 2016 | GREENVILLE BUSINESS MAGAZINE 19