Central Maine Healthcare, Bateman Partners move forward on another project

Photo / Maureen Milliken Central Maine Healthcare has announced plans for a 20,000-square-foot ambulatory care center on or near its Topsham Care Center at 105 Town Fair Mall Road in Topsham.

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By Maureen Milliken

Central Maine Healthcare and Bateman Partners LLC are moving forward on plans for an ambulatory care center in Topsham, the latest in an ongoing development partnership.

The Lewiston-based health care system plans a 20,000-square-foot ambulatory square center in Topsham, on the same site as the Topsham Care Center at 105 Topsham Fair Mall Road, which opened in September 2018.

The center was Bateman's first project with CMH. Since then it's also developed Maine Urgent Care in Lewiston, which opened in March, and is the developer of the 50,00-square-foot Central Maine Cancer Center, planned for the CMH Lewiston campus.

CMH filed a letter of intent for the $14 million Topsham ambulatory care center with the state Department of Health and Human Services May 8. The center will offer outpatient breast health, surgical oncology, orthopedics, gastroenterology, urology and ear, nose and throat surgeries. The letter of intent precedes a formal application for a certificate of need, which CMH will file shortly, a news release said.

The Topsham Fair Mall Road care center site, in a former Best Buy and connected smaller retail units, is owned by Bateman. The developer leases it to CMH. It owns the other developments as well.

The partnership allows CMH to focus on health care without a large capital outlay, said Jeff Brickman, CEO of CMH.

"It's an increasingly common model by health care systems," Brickman told Mainebiz this week. "Many health care systems are looking at where to spend their health care dollars." He said that means, increasingly, not investing in bricks and mortar. "They're looking to invest in technology, they're looking to invest in staff, they're looking to invest in information technology.

"These projects have a modest footprint, and a relatively modest cost," Brickman said. "If we were ever to do a large-scale hospial project, we would finance that on our own."

Bateman has "been extremely good as a partner" on the projects, which began with Topsham Urgent Care in 2017. He expects more in the future. "We've been impressed with their work."

"They're local, they're well-known, they're dependable," he said. "They believe in giving back to the community."

Nathan Bateman, Bateman Partners vice president said the feeling is mutual. "Working with CMH is rewarding in many ways," he told Mainebiz in March as the Lewiston urgent care center was poised to open. "As a developer, it's great to be part of projects in the health care industry that allow us to make a meaningful contribution toward more affordable health care.

"From our perspective, If we can deliver health care infrastructure that is cost effective, this allows our partners to be more accessible to the patients, which ultimately is the priority," Bateman said.

Photo / Maureen Milliken

The Topsham Fair Mall is part of the 750,000 square feet of retail space on the road where Central Maine Healthcare plans an ambulatory care center.

Bringing more to the Midcoast

The $14 million ambulatory care project is being developed in response to requests from patients, independent providers and insurers, CMH said in a news release. The building will have two operating rooms and four procedure rooms.

"The ASC will serve a region that currently lacks an outpatient alternative to more expensive in-hospital care," said the release. "ASCs enable patients to receive routine surgeries and treatments without being admitted to a hospital and to return home the same day."

CMH first made inroads into the Midcoast region with Topsham Family Practice several years ago. In 2012, the company sought to partner with 55-bed Parkview Medical Center in Brunswick under a change of control request. Parkview would have become part of the Central Maine Healthcare network. CMH withdrew the request in 2013, and Parkview ultimately merged with Brunswick’s Mid Coast Hospital.

The plan to develop the former Best Buy site, which had been vacant since 2016, began in 2017. The Topsham Care Center includes New England Cancer Specialists, Shields Health Care Group, Central Maine Specialty Care and Central Maine Urgent Care.

There are a variety reasons CMH likes the area, and the site.

Aside from adding complementary services to its urgent care center, and the need that that the system expects to fill, it's a great area for doing business. When the Topsham Care Center was being developed in 2018, Chip Neilson, director of business development for CMH, said, "It's the perfect space."

CMH officials reiterated that this week. “The Topsham Fair Mall location is convenient and accessible — right off the interstate, adjacent to residential areas and located in the heart of the Midcoast," said Kate Carlisle, director of public relations and community affairs for CMH. "Mainers deserve this access near where they live, shop and play.”

The CMH site shares space with a Buffalo Wild Wings restaurant, and is next to the Topsham Fair Mall, which has a Hannaford supermarket, Renys department store and more. On the other side of the CMH site is a retail area anchored by a Target department store. Home Depot is a little farther down the road. In all, there is about 750,000 square feet of retail space along Topsham Fair Mall Road.

Interstate 295 runs behind the lot, and the retail area opens up to Route 196, which links the Midcoast to Lewiston and Auburn.

Photo / Maureen Milliken

Central Maine Healthcare plans a 20,000-square-foot ambulatory care center on some of the land near its Topsham Care Center.

Plan not slowed by COVID-19

The building will be on one of the lots on the site where CMH's current buildings are.

"There are a couple of out lots we control in front of the building," Brickman said "We're considering which out lot within that footprint it will go, so all of those medical activities can be together."

Planning for the proposed ambulatory surgical center began before the COVID-19 pandemic shifted the health care system's focus and caused a drop in revenue that has led to furlough of 300 employees system-wide.

Brickman said no resources have been or will be diverted from CMH’s response to the pandemic or its ongoing commitment to providing care at Central Maine Medical Center and other CMH sites. In fact, he said, the issues surrounding COVID-19 make the time right.

"These plans were part of our original strategic plan when we created it three years ago," Brickman said. "And as we looked at our model to be a value-based health care system, we came to realize that more and more care needed to be perfomred in an outpagient setting.

"In sitting through the last couple of months of COVID work, we realized that now is as good a time as any to begin the discussion with the state on taking this model of surgical care and bringing it into another one of our communities, understanding that people are hurt by this ecomomic crisis that's resulted from COVID," he said. "They are looking for lower-cost more accessible points of care, and if we continue this model of unbundling care from hospital campuses, we'll be in more position to meet the needs of our communities at a time when they really need it."

He said that the plan, and others like it in the future, are still important. "This is really about the future of health care in Maine," he said.

Hospital officials have said that in-hospital surgeries are projected to decrease over the next decade as patients increasingly turn to ambulatory centers.

"As the government and insurance companies scrutinize costs and push toward more value-based care, outpatient surgery is expected to increase by 11% in the next two years," the release said. "The federal government has responded by adjusting Medicare payment policy to be more favorable regarding ASCs."