CLINTON — MercyOne’s busy year began with a rebranding of of its former self, Mercy Medical Center Clinton, followed by an agreement to partner with Medical Associates to provide comprehensive county health services.

“It’s an employment agreement, so it wasn’t a true legal acquisition,” said MercyOne Executive Vice President and Chief Operating Officer Amy Berentes in August.

“We call it an integration,” said Michelle Waltz, interim senior vice president of MercyOne Clinton Medical Group. Waltz has worked for Medical Associates since 2001, she said.

The partnership was something both corporations had looked at “for quite awhile,” said Julie Dunn, executive director of MercyOne Clinton Foundation and marketing. “This is something, really, that was no surprise.”

“I think the goal for both parties was to stabilize the medical community,” Berentes said. “I think there’s a real collaborative spirit, I’ve been so pleased with the way everyone’s come together.”

The merging of the services was a result of a loss of doctors in the community, Berentes said. During the past three years about 17 physicians stopped practicing in the community. Some retired. Some left, she said.

Medical Associates was a major employer of physicians in the Clinton area, Berentes said. Mercy employed only two. The hospital saw a need for more physicians and began hiring, employing 15 physicians and advanced practice providers by the time MercyOne integrated with Medical Associates.

Medical Associates was a partnership, Waltz said. For 55 years, doctors bought in to the partnership, working for themselves through MA rather than as employees of MA.

With the soaring price of medical school and rise in student loan debt, “It became a less attractive model to the new graduates,” Berentes said. Finding and retaining physicians became difficult for MA.

Medical Associates knew that in order to turn things around, to bring physicians back to the community, something had to change, Berentes said. “[It] didn’t have anything to do with compliance.”

“It was the economy,” Waltz said. For physicians, becoming employees was more attractive than joining a partnership

Now physicians can simply practice medicine, Berentes said. MercyOne takes care of the business part.

“Change is hard,” said Waltz, and sometimes the MA physicians were nervous and hesitant about combining services, but the more they worked toward integration, the more they saw its potential, she said.

“[It’s] very hard to go from physician owner to employee,” Berentes said, but the MA staff will be part of strategic planning and culture work. “[There are] new standards of care they will have to meet and [that] we will help them meet.”

The integration will rid the companies of duplicate services that were costly and unnecessary, Berentes said. Often the companies competed for those services, Waltz said. Now on the same team, the medical centers will eliminate redundancies and save money.

“We had two MRI machines, said Berentes. The machines are expensive and the volume of patients in the community is not large enough to warrant having two, she said.

CT scanners, bone scanners, radiology tests and labs can be shared between MercyOne and MA without leaving patients wanting, Berentes said.

“We’re also running 2 [operating rooms],” Berentes said. “We don’t really have enough volume to run 2 ORs… so we’re moving the surgeries [to MercyOne].”

“It’s not that we eliminated everything” Berentes said, but where they can the companies are eliminating duplicate services, making their operation more efficient and more cost effective.

“The average operating margin in Iowa is very small,” Berentes said, so every cost saving measure matters.

In most cases patients will continue to see their doctors at their usual locations, Berentes said. Most physicians will stay where they are.

Some specialists may move to the hospital, and some primary care doctors may move from the hospital, but for the most part, primary care and internal medicine will be at North Health Plaza (the former Med Associates building) and specialists will be at the hospital where they are most needed, Berentes said.

The overall vision of MercyOne and MA is stability and retention “so we can make sure we have good health care for the community,” Berentes said.

The change to patients is negligible, Waltz said. “Their bill will have a different logo. Some services have transitioned to the medical center site.”

The integration of the two companies will not result in an increased cost to customers, Berentes said, but that doesn’t guarantee lower medical costs. The health care industry is experiencing “continued increase in the cost and decrease in reimbursement,” Berentes said.

MercyOne Clinton is a Catholic, nonprofit community health center serving eastern Iowa and western Illinois, admitting nearly 50,000 patients a year to its 249 licensed beds, according to MercyOne marketing material.

MercyOne Clinton has a staff of more than 800 employees, making it one of the community’s largest employers.