photo by: Ashley Golledge/Journal-World File Photo

The emergency entrance to Lawrence Memorial Hospital is shown in this file photo from Jan. 26, 2018.

LMH Health is continuing to make progress in extending a contract with the local company that has been managing the hospital’s emergency department for more than 25 years.

A committee of medical professionals at the hospital was told at a special meeting Wednesday evening that contract negotiations with Lawrence Emergency Medicine Associates were going well. The contract had become a point of controversy after LMH executives earlier this month announced they were going to create a new contract with a large national firm.

After multiple members of the local medical community expressed concern, hospital leaders backed away from that plan and agreed to begin negotiating again with LEMA.

“I would say that I’m not just hopeful, but I’m quite optimistic,” LMH CEO Russ Johnson said of a possible deal.

Dr. Scott Robinson, president of LEMA, said he also thought the two sides were nearing a deal.

“It would be naive to say it is a done deal, but realistic to say both of us are committed to find a mutually agreeable deal,” Robinson said.

LEMA is responsible for hiring all the doctors and other advance practice providers who staff the emergency department, while the hospital employs nurses and other personnel. Concern began growing in the community after hospital executives announced a tentative deal to partner with Envision Physician Services. The hedge fund-owned company had been in the news for financial problems and billing concerns, and several doctors expressed concern about whether they would cut staffing levels at the emergency department.

LMH executives, with direction from LMH’s board of trustees, paused negotiations with Envision and eventually ended those discussions. LMH and LEMA now have entered an agreement to negotiate exclusively for the next 90 days. Both Johnson and Robinson, though, said they thought a deal would be completed before the end of the 90-day period.

The contract with LEMA also includes providing doctors for LMH’s hospitalist program, which is a group of doctors who provide care for patients receiving inpatient care at the hospital. Both sides said they are now considering removing the hospitalists from the LEMA contract and creating a contract where those doctors become more akin to LMH employees.

Wednesday’s meeting with LMH’s Medical Executive Committee also addressed ways to avoid future contract negotiations with medical providers turning into the type of controversy that has emerged surrounding the LEMA matter.

Johnson said the hospital’s board of trustees would be reviewing a new, formal process for contract negotiations that he thinks will do a better job of providing notice, creating clear lines of communication and eliminating surprises during the process. Various hospital leaders on Wednesday said they had not done enough to communicate during the early stages of the LEMA process.

Johnson said he was committed to making sure communication was better in the future.

“I have felt all along that I have good relationships with physicians, but they need to be deeper and and stronger,” Johnson told the group. “That has been somewhat painfully apparent through this process.”

As for next steps, both sides said they were continuing discussions. Originally, financial considerations played a major role in LMH’s initial decision to partner with Envision. Johnson had estimated that the hospital might have ended up paying Envision $5 million less over a three-year period to manage the emergency and hospitalist departments than it would pay LEMA.

The parties didn’t provide any update on the financial aspects of their discussion, but Robinson said a major issue is trying to figure out whether demand for emergency department services is still growing in Lawrence. The department had consistently seen an increase in the number of patients it serves for many years, until 2019. Volumes declined last year, and the COVID-19 shutdown is expected to have an impact on numbers this year.

“We really don’t know if we are going to see 38,000 patient visits or 35,000 or 30,000,” Robinson said. “Those numbers markedly impact our staffing levels. If there is anything that is going to cause us indigestion going forward, it will be that.”