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As others see it: Exploring a merger

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'Exploratory talks" is the way representatives of two major North Dakota hospitals described the possibility of a merger. Sanford Health's Fargo unit and Medcenter One in Bismarck said they are discussing coming together. If it happens, the reach of Sanford/Medcenter One would extend from northwestern Minnesota to the Montana line, not including Sanford in Sioux Falls, which covers much of South Dakota, a large swath of southwestern Minnesota and pieces of Iowa and Nebraska.

The revelation of discussions between the two hospitals is reminiscent of the initial phases of the Sanford/MeritCare relationship, which resulted in a complete merger of the two regional health care giants. Moreover, opposition to the merger from prominent Fargo community and business leaders dissipated quickly as Sanford delivered on commitments it made to Fargo. Indeed, nearly everything -- and more -- that Sanford said it would do in Fargo has come to pass or is in planning stages.

If the Bismarck "exploratory talks" evolve the way they did in Fargo, the reaction among some residents of the capital city will mirror what happened in Fargo. After all, Medcenter One is not only an excellent hospital, it's also an icon of Bismarck's identity, just as MeritCare was for Fargo.

While it's early to conclude a merger will happen, executives of Sanford Health and Medcenter One readily confirmed they are seriously discussing their options. ...

As the nation's health care sector positions itself for sweeping changes in patient care and payment models -- including the unknowns of the federal health care reform law -- economies of scale seem to be driving mergers and other affiliations (Grand Forks Altru and Mayo of Rochester, Minn., for example). The success of mergers relies on perceptions of patient-centered care and impacts on communities. Thus far, Sanford in Fargo is passing the test. There is little reason to believe it won't happen the same way in Bismarck if the Medcenter One merger is accomplished.