The boards of Haywood Regional Medical Center and WestCare Health System are officially seeking proposals from three hospital systems that will likely result in an affiliation with one of them.

The document lays out the primary advantages of HRMC’s and WestCare’s affiliation with one of the larger healthcare systems.

“Affiliation is necessary at this time to meet the challenges posed by declining Medicare and Medicaid reimbursement, technological change, and the regional growth of other hospital systems,” the document states.

Haywood Regional and WestCare leaders have been refining the wording of their requests to the other hospitals for two months. Haywood Regional would only provide a summary rather than make the full document public, however, despite being a public hospital that falls within the N.C. Public Records Law. Hospital officials cited the need for confidentiality in the negotiations.

An affiliation has been a likely scenario for Haywood Regional Medical Center since the hospital temporarily lost its Medicare status this year, causing a near shut-down of the hospital for five months and a major blow to its finances. WestCare is also suffering declining revenue, prompting a workforce reduction.

HRMC CEO Mike Poore has said previously that HRMC chose to partner with WestCare in the search for an affiliation because of its proximity and similarities. The hospitals are both small, in rural areas and have similar missions, Poore said.

WestCare Board President Jerry McKinney has voiced his hopes that WestCare could possibly grow and improve its services if affiliated with another hospital.

WestCare officials have said the hospital’s recent economic troubles — it lost $3.2 million between June and August of this year — have nothing to do with the decision to partner with HRMC.

Proposals from the partner hospitals must be submitted by Jan. 30. The RFP asks the potential partners to lay out specific steps and an anticipated timeline for the affiliation.

The joint study committee, comprised of the board members from both HRMC and WestCare, will start reviewing proposals in February, according to Poore. The boards of the respective hospitals will make the final decision.

The request for proposals pose a series of questions, including:

• How will the partner hospital integrate its operations with HRMC and WestCare?

• How will the partner hospital maintain and enhance clinical services?

• How will an affiliation improve patient access to care in Haywood, Jackson, Macon, Swain and Graham?

• How will the partner hospital help with physician recruitment?

• What is the estimated economic value of each affiliation?

• What are the vision and strategies of the partner hospitals, including organization size, such as number of hospitals and physicians, and geographic reach?

• How would an affiliation benefit HRMC and WestCare?

• Miscellaneous information, such as patient satisfaction scores; how employee satisfaction is measured; policies for staff recruitment and retention; and how patients and families are incorporated into decision-making.

Who gets to play?

WestCare and Haywood Regional Medical Center invited three hospital systems to make a formal pitch of what they could offer should the hospitals chose them as their future partner.

Carolinas Healthcare System is the largest of the three potential partners, with 18 hospitals based mostly around the Charlotte metropolitan region. Novant Health owns nine hospitals in Charlotte, Winston-Salem and on the coast. Mission Health System is the smallest, operating four hospitals in the mountain region.