A state panel is recommending that health-care providers in Moore and Cumberland counties be allowed to provide medical services in neighboring Hoke County.

Fayetteville-based Cape Fear Valley Medical System had asked the state this summer to shift Hoke to the Cumberland County planning region under the 2010 State Medical Facilities Plan. Pinehurst-based First-Health of the Carolinas opposed the request.

Under the current plan, Hoke is in the same planning area with Moore County.

The State Health Coordinating Council (SHCC) on Friday approved the change. Its recommendation now goes to Gov. Bev Perdue, who has final approval.

The state council is responsible for developing the medical facilities plan each year. Its recommendations go to the governor for final approval.

Regardless of what the state ultimately decides, it will not affect pending certificate of need applications by the two health-care providers to build new hospitals to serve Hoke County. That decision will be governed by the 2009 state plan.

"The SHCC's decision rejected Cape Fear Valley's petition to re-align Hoke County with only Cumberland County for future applications and approved a model to 'share' service areas," said FirstHealth CEO Charles T. Frock. "FirstHealth recommended the state study multi-county service areas before rendering a decision. Nevertheless, we believe the citizens of Hoke deserve facility-based services within Hoke County, and if this decision gets them closer to that reality, then we will operate within that framework.

"FirstHealth's own data and experience show that Hoke residents prefer to access highly specialized services at Moore Regional Hospital in most clinical areas. We don't expect Hoke residents' preference for FirstHealth's high-quality health care to change even if the planning district is realigned."

FirstHealth has proposed building a $30- to $35-million, eight-bed hospital on U.S. 401 in Raeford. It would also have four observation beds and one operating room and would provide 24-hour emergency services, diagnostic imaging, laboratory services and a pharmacy. It would also have a heliport.

It would be completed in October 2012. FirstHealth officials said the hospital could be expanded to as many as 100 beds as the county continues to grow.

FirstHealth and Surgery Center of Pinehurst have also filed a separate application for state approval to build a $4.6 million freestanding ambulatory surgery center on the proposed Hoke Hospital campus. It would also have two operating rooms that would be relocated from the Pinehurst facility.

Cape Fear Valley has proposed a $79-million, 41-bed facility just over the Hoke County line on Raeford Road in Cumberland County. It cannot build the facility inside the county under the current state plan.

A final decision is expected next month from the state.

Cape Fear Valley argued in its request to align Hoke and Cumberland counties that the current state plan is based on numbers dating back to 2002, when a majority of Hoke County residents went to Moore Regional Hospital in Pinehurst for services. It says those numbers have shifted the other way, as a result of the growth in eastern Hoke County -- mainly among military families. It expects that trend will continue as Fort Bragg expands as a result of BRAC.

It says in its application that the number of days Hoke County residents spent in the hospital in Cumberland County was up 8.6 percent last year, while the numbers were down for the number of days residents were hospitalized in Moore County.

"This increase for Cumberland County and decrease for Moore County is a continuing trend, not a one-time change," Cape Fear Valley said in its application.

FirstHealth countered that over the last four fiscal years, FirstHealth provided more (42 percent) of the acute inpatient care for Hoke County residents that any other single provider. FirstHealth also said it had more discharges in 19 areas, such as cardiology, vascular surgery, general surgery, orthopaedics and pulmonary.

It argues that Cape Fear is seeking a change in the state plan on the basis of a one-year change.

"FirstHealth still provides a very significant amount of care to Hoke County residents," said Amy Graham, director of business development for FirstHealth, in a filing with the state.

One area in which Cape Fear Valley saw an increase was obstetrics. "Cape Fear Valley Medical System is asking for a change based mostly on obstetrics," FirstHealth said in opposing the request.

FirstHealth also said it "actively works to decrease the length of stay," which helps lower costs. But the methodology used by the state actually "rewards hospitals that don't make an effort to reduce the amount of time patients are hospitalized.

One of the recommendations adopted by the SHCC calls for updating the methodology for determining the need for acute-care beds and operating rooms in the 2011 medical facilities plan.

FirstHealth officials added that if the state approves its application to build a hospital in Raeford, Hoke County would become its own service planning area, rendering Cape Fear's application to align Hoke and Cumberland in the 2010 plan "moot."

Contact David Sinclair at (910) 693-2462 or by e-mail at dsinclair@thepilot.com.