Providence takes immense pride in its Orange County family of organizations, as our history in the region dates back nearly 100 years, when the founding Sisters of St. Joseph of Orange opened one of the area’s first modern hospitals. Today, Providence St. Jude Medical Center, Providence St. Joseph Hospital of Orange, Providence Mission Hospital, Hoag and Providence Medical Groups work together to provide nationally recognized, leading-edge care to all of Orange County. However, Hoag has recently taken legal steps to leave our affiliation, which we oppose on the basis that this would lead to fragmentation and decreased quality of care in the region. For more information, please see the following FAQ.
Providence OC is a campaign in support of Providence's Orange County family of organizations, including Providence St. Jude Medical Center, Providence St. Joseph Hospital of Orange, Providence Mission Hospital, Hoag and Providence Medical Groups. We firmly believe that we are stronger when we come together in pursuit of Providence's Mission of providing quality, compassionate care for all, especially the poor and vulnerable. Now, during the coronavirus pandemic, it is more important than ever that we present a united front against the COVID-19 pandemic, as it is the health and wellness of the communities we serve that matters most.
Providence traces its roots back to 1856, when the Sisters of Providence established hospitals, schools and orphanages across the Northwestern states. Similarly, in 1912, the Sisters of St. Joseph arrived in Eureka, California to provide education and health care. A decade later in 1922, they relocated their motherhouse to the city of Orange and later broke ground on St. Joseph Hospital in 1928. This treasured history is at the core of why Providence's Mission extends beyond the walls of primary care and acute care settings and into the neighborhoods of the communities it serves through community benefit and charity care programs. At Providence, we are steadfast in serving all, especially the most poor and vulnerable.
St. Joseph Health and Hoag Memorial Hospital Presbyterian (Hoag) joined together to form St. Joseph Hoag Health in 2012. Four years later in 2016, St. Joseph merged with Providence Health & Services, creating the present day Providence health system. The 2012 affiliation occurred during a time of immense struggle for Hoag with the loss of the largest physician network (IPA) and management services organization (MSO) affiliated with the hospital. St. Joseph Health warmly welcomed Hoag into a family of wonderful hospitals, the Providence Medical Groups and services outside the walls of our hospitals with the intent of strengthening Hoag and the entire Orange County and High Desert network together.
The affiliation agreement entered into in 2012 expressly provided that the affiliation would be a permanent one, and that permanency has been reaffirmed several times since then, including as recently as 2017. St. Joseph Health, and later Providence, have invested significant resources to support Hoag over the past eight years in reliance on the permanency of the affiliation. There is no dispute by Hoag that the affiliation agreement remains a legally valid and enforceable contractual obligation, and Hoag does not have any ability under the agreement to leave the affiliation unilaterally.
Hoag presented Providence with a request to disaffiliate from its existing relationship in July of 2019. Given the years of accomplishments and work together to advance the combined entities in Orange County and High Desert, we were surprised by the request. Nevertheless, when the request for realignment was made, Providence agreed to review it and attempted for months to find a pathway for Hoag that would prove mutually beneficial and not disrupt our years of collaboration, which would slow the advancement of health care in Orange County.
No, exactly the opposite. In the past eight years since the merger, Hoag has requested numerous amendments to be made to the affiliation agreement. For example, Hoag requested that the Hoag Medical Group that was developed with Providence Medical Groups be allowed to move out of that combined structure and into its own structure. When Providence agreed to this request from Hoag, along with various other amendments, this reaffirmed Hoag’s intent to remain within Providence and Covenant Health Network (CHN). Each time Hoag signed these agreements, they validated the original intent of the affiliation— that it would be in perpetuity.
In the midst of a dispute resolution process between our organizations that is required under the affiliation agreement, Hoag violated a mandatory provision in the agreement that required Hoag to participate in good faith mediation efforts for a specific period of time before filing any lawsuit. We are disappointed that Hoag decided to violate the agreed-upon process by commencing a lawsuit before the contractually required mediation period had expired. Hoag chose to take this legal action in the midst of an unprecedented pandemic, when even the Orange County courts were not open for non-emergency civil lawsuits such as this.
Hoag's lawsuit does not challenge the validity or enforceability of any aspect of the affiliation agreement. Instead, Hoag filed a complaint seeking the involuntary dissolution of CHN under a California statute that allows for this for non-profit entities only under narrowly delineated circumstances such as when the entity is unable to perform its purposes or operations. We believe the lawsuit is without merit and intend to vigorously defend against it, in the best interests of our community and stakeholders that benefit from the affiliation.
Despite claims by Hoag that it’s been “swallowed up,” the accusations remain vague, unfounded and without basis. The facts are that Hoag has never been prevented from taking any action or decision that it wished to take. Under the affiliation, Hoag has its own discretion whether to use clinical protocols, supply chain contracts, or other system-scale initiatives – nothing has ever been forced upon Hoag, ideas and suggestions have only ever been offered up for consideration. For example, Providence is able to leverage significant purchasing power as a result of its national scale, and participates with a group purchasing organization called Vizient for supplies purchased at our hospitals. At a higher cost, Hoag unilaterally chose not to use Vizient and instead use Premier Inc. GPO. This of course is Hoag’s decision to make, and a prime example of Hoag being allowed to make its own choices.
Yes, in numerous ways. Since the formation of the affiliation, Hoag recovered from the distress it was in prior, Hoag and Providence Medical Groups stabilized and our united network grew the number of medical foundation physicians dedicated to Hoag to more than 100 clinicians. Specifically, the affiliation has enabled Hoag to participate in Providence Clinical Institutes, collaboratively developing and deploying best practice clinical protocols to its hospitals.
In the first year of the affiliation alone, hospitalization and readmission rates were reduced and emergency room visits were lowered by 10,000. Providence has also made numerous investments in Hoag, such as the Hoag Orthopedic Institute, the development of an ambulatory platform and Epic at Hoag, one of the nation’s leading electronic medical record systems.
Yes--the affiliation has provided access to Orange County’s premier care network – meaning more locations in a multitude of practice areas, greater access to specialists and top doctors, innovative and leading-edge treatments, collaborative and innovative efforts, and overall better value and community care for lower costs. Additionally, Providence has made significant investments in partnerships focused on whole person care, such as mental health and substance abuse disorders in Orange County through organizations like BeWell Orange County.
It's clear that the affiliation has only led to greater resources and investments in comprehensive, compassionate care, working in an effort to improve individual patient and community health outcomes throughout the Orange County region. For more information on the great work Providence has done in Orange County, please visit our News page.
Since the start of our affiliation, Providence has provided extensive resources, expertise and state-of-the-art services and care to Orange County patients, and will continue to do so during these trying times. For example, during the current COVID-19 pandemic, Providence made it possible for Hoag to participate in the experimental Remdesivir drug clinical trial, extending a potentially promising treatment to Hoag patients, and illustrating the benefits once again of the affiliation – this time during an unprecedented and on-going health crisis. As Hoag is an affiliated partner of Providence, we believe it’s in the best interests of our communities to continue to act as a unified front against the COVID-19 crisis. For more information on how Providence has served the community during the COVID-19 pandemic, please visit our COVID-19 page
Hoag has claimed that the two systems’ religious beliefs, values and policies are not aligned, compromising and restricting some of its services. At our core, both Hoag and Providence are more alike than different, both being faith- based with a community driven Mission of providing the highest quality healthcare to those that they serve. Providence is committed to continuing to fulfill its Mission.
No— Hoag is not bound by the Ethical and Religious Directives for Catholic Healthcare, and therefore has no impact on Hoag’s ability to provide services it chooses to offer. This is a requirement contained in the affiliation agreement.
Since the formation of the affiliation, women’s services at Hoag have actually improved. Hoag has been the recipient of the Women’s Choice Award for Heart Care and Obstetrics for the past six years. Along with our other Orange County hospitals, Hoag has received this award for meeting the standards carefully outlined by this outside organization.
We provide quality care to patients regardless of gender identity or sexual orientation. The inherent dignity of all is a moral teaching embedded in our core beliefs and tenets.
Absolutely not. For years, Providence has advanced efforts in population health. Hoag’s claim is particularly puzzling, given that the Hoag board approved the Orange County and High Desert strategic plan that was presented to them in January 2020, which specifically outlined objectives to improve population health. Furthermore, at a recent Hoag board meeting, Providence Southern California Chief Executive Erik Wexler explained that the term “population health” is an outdated one and that the more contemporary terminology is a “value-based care provider.” This phrase not only speaks to the essentiality of keeping the population healthy, but also doing so in a way that allows for less financial impact on the patient and society, improving patient experience and bringing care closer to home in our individual communities.
Hoag made no claim or assertion regarding any of Providence’s, Hoag’s and CHN’s combined “population health” initiatives and efforts at any time during the nearly decade-long affiliation, making this claim for the first time only after it sought to disaffiliate from Providence in July 2019. Under the terms of the agreement, “population health” is just one of many different purposes for which CHN and the affiliation was created and continues to fulfill today, and Hoag has not made any allegations concerning any of the other multiple purposes of CHN.
Providence believes that there is still much to be accomplished through the affiliation, and that our patients, providers and all of our stakeholders in the Orange County community are stronger together than apart. CHN and the affiliate continue to provide positive and vibrant health care and wellness for all of the members that we serve through our partners. We will continue to engage in dialogue with Hoag to find a meaningful resolution that protects health care in the communities we serve, and as demonstrated by Providence’s willingness to make changes to the affiliation agreement over the years whenever requested by Hoag, we are willing to consider and address any legitimate issues that may be raised.
Hoag continues to have a voice through the designation of several directors to the CHN Board of Directors, and we look forward to continuing to collaborate and support all of our partners. Although it is too soon to know what the outcome will be of Hoag’s lawsuit, the litigation process is likely to be lengthy and unresolved for years, particularly given the current effects of the pandemic on the judicial system. Providence is ultimately here to serve the greater good of the Orange County community, and will be guided in all of its decisions by its core mission and purpose of providing comprehensive, compassionate care to all we are honored to serve.
The affiliation remains in place and all of the requirements of the affiliation continue. If Hoag persists with its lawsuit, it could be a year or longer before the matter is resolved. In the meantime, we will continue to serve our patients with compassion and with continued appreciation for Hoag as an affiliate of our organization – as it’s the health and well-being of patients and communities that is the most important.