Jim Alender has been CEO of Howard Regional Health System in Kokomo since 1997. He recently negotiated a letter of intent to merge the hospital with Indianapolis-based Indiana University Health. He spoke about the major factors that led to that decision, and the benefits he hopes to come from it.

IBJ: What were the factors that forced Howard Regional to look for a larger hospital system to join?

A: We’ve had a very challenging last two years in the social demographics and in the work force in Howard County. And we are seeing an aging population. The loss of the volume from a commercial population led us to look for a partner. A larger system will help us spread costs over a larger base. Also with health care reform, we felt coordination of care being emphasized. [Integrating with IU Health] is starting the first steps of an accountable care organization.

IBJ: What are the main benefits you think will come out of Howard Regional’s integration with IU Health?

A: For patients, you want to give much more convenient access to the advanced therapies and treatments they’re going to receive. For our medical staff and our employees, obviously it’s the opportunity to advance their own professional patient care practice, to have access to technologies that we currently don’t have. We believe that branding with IU Health will obviously help us recruiting physicians, particularly in subspecialties. It is hard (recruiting to a smaller city), but having the opportunity to brand with IU Health is obviously going to help us. Also, we’re going to provide those higher-paying jobs. I believe that’s really important for the community as it tries to diversify away from automotive manufacturing.

IBJ: In recent years, Howard Regional leaders have discussed moving into more high-end services, such as cardiology, neuro, gastro, orthopedics and imaging, and to expand those services outside of Howard County. Will those still be your aims under the IU Health umbrella?

A: We’ve introduced cardio, ortho and gastro. We probably won’t have neurosurgery; there’s just not a critical mass. We’re looking at developing a regional medical plan for the region. And working with providers in the region. We haven’t defined that yet, but clearly Howard and its contiguous counties would be a good region.