Ascension Health Alliance partnering in Cayman Islands 'health city'

May 1, 2012

System will invest in project along with Indian hospital developer


St. Louis-based Ascension Health Alliance is partnering with an Indian hospital developer on an approximately $2 billion venture that will establish a for-profit "health city" in the Cayman Islands. The partners will open a tertiary care hospital next year, and by 2027, the development likely will include a medical and allied health school, a biotech park and an assisted-living facility.

"This is a continuation of our efforts to care for all who need it — and we do that both in the U.S. and abroad," said Anthony Tersigni, president and chief executive of Ascension Health Alliance. "Our vision is to help take care of the people of the Caribbean — to bring services to the people of the island."

Developers expect to hold a ceremonial groundbreaking in August on their 200-acre tract on Grand Cayman Island. Facilities and service lines will be developed in phases. The first phase — a 140-bed tertiary care hospital — will open early next year and will initially focus on providing cardiovascular services including open-heart and bypass surgeries and orthopedic services including joint replacements. Additional specialty services, including cancer treatment, bone marrow transplants, nuclear medicine and organ transplants, will be added over time. Once the medical center is complete, it will have as many as 2,000 beds.

According to the Central Intelligence Agency's World Factbook, the Caymans have a population of 52,600, most of whom live on Grand Cayman Island, the largest of the three islands in the Western Caribbean nation. The islands are about 480 miles south of Miami. According to the Factbook, the Caymans are a "thriving offshore financial center" and luxury tourism destination where the standard of living "is roughly equal to that of Switzerland."

The health city's medical school and allied health school would be linked to the University College of the Cayman Islands. The partners have yet to disclose their plans for the biotech park.

The hospital will seek accreditation from the Joint Commission's international arm.

Ascension Health Alliance and Narayana Hrudayalaya Hospitals are funding the project. They are not disclosing the sums each might invest.

Narayana Hrudayalaya will lead the development of the health city. The 11-year-old company has established about 20 health care facilities around India, including health cities where patients can receive a wide variety of services. Narayana Hrudayalaya facilities treat both Indian nationals and medical tourists.

Dr. Devi Prasad Shetty is chairman and director of Narayana Hrudayalaya and a cardiovascular surgeon. He is known for wringing costs out of health care delivery at his facilities — while still providing high-quality care — according to John Doyle, executive vice president of Ascension Health Alliance. Tersigni noted that one way that Shetty does this is by reducing variation in clinical processes.

According to Tersigni, Narayana Hrudayalaya facilities can perform open-heart surgeries for as little as $1,700 per surgery, whereas an open-heart procedure can cost well upwards of $20,000 in the U.S. The Indian company has developed hospitals at a cost of about $20,000 per bed, whereas it costs about $1 million per bed in the U.S., he said.

"And this is just the tip of the iceberg" on cost control, said Tersigni.

Shetty long has wanted to expand his model of providing care beyond India, and he has been in talks with Ascension Health Alliance for about two years about a potential partnership. He attracted the attention of the Cayman Islands government, and island officials initiated talks with him about bringing health care services to the region, according to Doyle.

Tersigni explained that Ascension Health Alliance was drawn to the project because it extends the system's international aid work. He said the Cayman Islands and other Caribbean nations lack specialist services. Studies indicate that residents travel off-island to receive care valued at more than $100 million annually, said Tersigni. The Cayman Islands government pays much of these costs for its citizens.

Tersigni said the health city facilities will mainly treat people living in the Caribbean. While a press release announcing the partnership said the initiative will benefit the Caribbean region and the Americas, Tersigni said the focus is on providing "high-quality care for Caribbean residents at a low cost."

He noted that while the facility will be classified as a for-profit, it still will have a charitable mission, providing care to underserved and low-income people. It will abide by the Ethical and Religious Directives for Catholic Health Care Services. He added that as in the U.S., while the standard of living in the Cayman Islands is high, there are "always those who are poor and vulnerable and in need of care É Dr. Shetty shares our commitment to providing care to all, so as the project takes shape, we are confident that there will be high utilization by both those who can afford to pay for care and those who cannot."

He said that the Cayman health city "will provide Ascension Health Alliance and its subsidiaries opportunities to examine and learn about different approaches to providing health care to all with special attention to those who are poor and vulnerable. These learnings can benefit facilities in the U.S. and worldwide," he added.

Tersigni and Doyle noted that Narayana Hrudayalaya's mission and values are compatible with those of Ascension Health Alliance. Shetty's vision is to make care accessible to people of average and low means, according to materials from his organization. Tersigni mentioned that Shetty was Mother Teresa's cardiologist toward the end of her life. "She impacted him. He believes that the poor should not be forgotten," Tersigni said.

The complex will employ physicians, other clinicians and staff from the Caribbean and around the world.

In addition to providing funds, Ascension Health Alliance will provide facilities planning, supply chain management and biomedical engineering support for the project.

Doyle noted that Ascension Health Alliance expects to reap significant benefits from the partnership, particularly by learning from Shetty's model how to contain health care costs while maintaining high-quality care standards.


Copyright © 2012 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2012 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.