Billings Clinic feasibility study underway, WIA requesting funding for independent study

By Emily Stifler Explorebigsky.com Managing Editor

BOZEMAN – With an updated feasibility study in hand, Bozeman Deaconess Health Services is proposing a new medical center in Big Sky. Billings Clinic is not far behind.

“It’s been part of our strategic planning for the past 10 years to look at all of the markets in our service area and evaluate the community needs,” said Cheryl Ridgely, Chief Strategy and Business Development Officer for BDHS.

BDHS, which has operated a pharmacy in Big Sky since 2004 and owned a lot in Town Center since 2007, last conducted a feasibility study here in 2009. That analysis concluded it would take 5-7 years for a freestanding medical facility to be sustainable. No local tax support was assumed in that forecast.

“The projections then, given the permanent population, second homeowners and resort activity, was that there wasn’t a sufficient population to support a medical facility,” Ridgely said.

Things have changed.

The 2013 study shows the Big Sky area’s permanent and seasonal populations, employment base and economic activity have rebounded and are poised for sufficient further growth.

BDHS is now proposing a 33,000-35,000-square-foot medical center that would serve the Big Sky and south Gallatin County communities. It is proposed as a two-story building that initially would have five inpatient beds, expandable to 10, a primary care clinic and a 24-7 emergency department.

While BDHS doesn’t currently operate any critical access facilities, it has a “strong, long term commitment to Big Sky,” said BDHS CEO Kevin Pitzer, who was hired in April and has a background in rural health care administration. “We have a responsibility to serve the market area.”

Funded by operations and some philanthropic support, the proposed medical center would be fiscally sustainable in 3-5 years of operation, Ridgely said, contingent on volume and how it is used. BDHS estimates it would initially add 30 jobs to the local economy.

The building would be constructed in the Town Center, with initial site development this summer, and construction starting in spring 2014 and finishing the following summer.

“It’s very important that there is community support to move forward with this project,” Pitzer said. “Not from a funding discussion – that they view we’re the right partner to move forward to the benefit of Big Sky and the region down there.”

Pitzer and several BDHS trustees have presented the proposal to a number of stakeholders and leaders in the Big Sky community, including Big Sky Fire Chief Bill Farhat, the local physicians, general managers of several of the resorts, and members of the Big Sky Resort Tax Board.

“They laid out a plan of how they would bring a hospital to town,” Farhat said. “It was kind of exciting. They laid out how they would finance it and that they felt it was a viable opportunity, and that they really wanted to be here. It’s a comprehensive plan, well thought out, and it would be very good for us.”

Billings Clinic also conducted a feasibility study this year, but those results weren’t released until after press time.

“We’ve done more exploratory assessments of the situation, but this is a major study,” said Billings Clinic Foundation President and Community Relations Director Jim Duncan. “It will be a comprehensive assessment of the medical needs and opportunities and situation of the Big Sky community and region… We want to make sure we’re proposing the right mix of enhanced services.”

A Billings-based not-for-profit, community-governed organization, Billings Clinic is the largest health care organization in Montana. It manages 10 critical access hospitals in Montana and northern Wyoming and is part of the Mayo Clinic Care Network.

“In each of the communities that we’re in, it’s been a collaborative effort to figure out how best we could help and how best we could augment the services,” Duncan said. “Each relationship is different.”

It began looking into Big Sky a year ago, Duncan said, when a group of local community leaders approached Billings Clinic about its interest in helping to advance medical services for Big Sky.

Even with the study results, the Billings Clinic study won’t propose a specific facility when it talks to community stakeholders in early June, Duncan said.

“It’s premature for me to say that Billings Clinic is prepared to say we want to build a certain program,” he said. “It will be an ongoing dialogue that we have with the community leaders and the community as a whole… [We’d say], ‘Here’s what our feasibility study shows, you tell us what you think your list of desires is for the community.’ If we’re a good fit to be part of that, then we move forward from there.”

Tertiary care referrals from Big Sky wouldn’t necessarily have to go to Billings Clinic, and in fact many would still be sent to Bozeman Deaconess or Denver, he said. “That’s for the physician or the provider to decide.”

Duncan said Billings Clinic is very interested in exploring opportunities to work together with Big Sky, but emphasized that it “[likes] to work at the invitation of a community.”

Stroudwater and Associates conducted the study for Bozeman Deaconess Hospital, and by ECG conducted Billings Clinic’s.

Led by Big Sky resident and former hospital administrator Jack Eakman, the local social services nonprofit, Women in Action, is requesting Big Sky Resort Tax money to fund an independent feasibility study for a critical access hospital.

“We believe that both hospitals will be using their information to garner market share from Big Sky rather than open the information to each other and to the community for the Big Sky community’s own benefit,” Eakman wrote in an email to the resort tax board on May 21.

The WIA study, “if necessary, would be a community study; funded by the community through resort tax, heard by the community through open meetings, and lead to recommended improvements as the community sees fit,” Eakman explained.

BDHS plans to host an informational town hall meeting in mid- to late June, in which it will outline the scope and timeline for its proposal and answer questions from community members.

Billings Clinic has discussions planned with Big Sky stakeholders, and is planning to take their lead on future communications with the larger community, Duncan said.

As an unincorporated community with no official local government, what happens next is anybody’s guess.

“I frankly think either hospital would be a wonderful partner,” said Les Loble, chairman of the Big Sky Resort Tax Board. “But you have to recognize the long history that our community has with Bozeman Deaconess, because it’s the nearest hospital. We’ll just have to see how this plays out.”