Scott MacKay Commentary: Why The Care New England-Boston Partners Merger May Not Be So Great

Apr 21, 2017

Boston’s big hospital system –Partners HealthCare—is acquiring Care New England, Rhode Island’s second largest hospital chain. RIPR political analyst Scott MacKay says this deal raises many questions about the quality and price of health care in the Ocean State.

Partners HealthCare, a Boston hospital behemoth, is moving aggressively to expand its reach into Rhode Island’s multi-billion dollar medical market. Partners  runs some of the world’s most celebrated hospitals, including Massachusetts General Hospital and Brigham & Women’s Hospital. If you’re very sick, there probably isn’t a better place for care.

Yet, most of us aren’t that sick. What the majority of Rhode Islanders need is good primary care, that’s accessible and affordable. At this point, It’s difficult to see how this deal advances those goals, says Boston University School of Public Health Professor Alan Sager.

Under the arrangement announced last week, Partners would acquire the Care New England hospitals – Kent County in Warwick, Butler in Providence and Women& Infants, also in Providence. Memorial Hospital in Pawtucket, which is hemorrhaging red ink, would be spun off to the California hospital chain that currently owns Woonsocket’s Landmark Medical Center.

Partners is the largest and most expensive system of hospital and doctors in Massachusetts. It appears they are moving into the Ocean State to harvest more patients, which means more money and a larger empire. Massachusetts regulators have frowned on Partners buying up any more hospitals in that state, so Partners is expanding in New Hampshire and Rhode Island. Partners had about $12.5 billion in revenues last year, while Care New England took in about $1.2 billion. When Partners has taken over community hospitals in the Bay State, health care costs have increased.

Rhode Island’s Lifespan hospital system isn’t happy about this combination. With $2 billion in revenue, Lifespan, which includes Rhode Island, Bradley, Newport and Miriam hospitals, is the largest health care provider in Rhode Island, but has nowhere near the market clout of Partners.

Timothy Babineau, ceo of Lifespan, stated this clearly in an email to doctors, saying that it would be an ``unfortunate outcome’’ if the merger moves health care jobs and care to Boston. The Partners Care New England combination threatens to accelerate the trend of Rhode Island patients with Cadillac employer health care plans or personal wealth taking their hip replacements and heart surgeries to Boston.

Babineau is correct, but Lifespan’s hands aren’t clean. Lifespan has proposed a multi-million dollar program to start delivering babies at Rhode Island Hospital, which is less than a field goal from Women & Infants in South Providence. Why is Lifespan pursuing this, which can only lead to duplication of services and rising costs?

Then, of course, there are the bloated salaries of Lifespan executives, Including the $2.4 million annually that Babineau gets, which has long angered Rhode Islanders.

Gov. Gina Raimondo mentions jobs at every stop, but she’s so far been curiously absent on the larger issues of health care policy; no statements came from her administration on the day the merger was unveiled.  Her state health director, Dr. Nicole Alexander-Scott is a cipher; she never seems to have an opinion on the big issues in hospital care. The governor should be concerned about the impact of this new combination on jobs – Care New England employs roughly 8,000 workers in Rhode Island and Lifespan has 14,000. Many of these positions are among the best-paying, unionized jobs in the state.

Because the merger will require approval from the state attorney general and the health department, we may finally find out what Raimondo and Alexander-Scott think. There’s nothing like a tough decision at the beginning of an election cycle to wake politicians and regulators from their slumber. The same can be said for the General Assembly leadership, which in recent years has done little about the economic issues facing hospitals, except to block any attempt to close struggling health care facilities in their back yards.

The Partners move will force some of these issues into the open. Among the questions regulators should he asking: What is the impact on health costs? Partners big hospitals are affiliated with Harvard Medical School, so what happens to Brown’s medical school? What happens to the 70 medical residents being trained in primary care at Memorial? Will patients and medical research money be sent on a one-way train to Boston?

Until these and other questions are answered, Rhode Islanders should be wary of this plan. We too often forget that most hospitals are non-profits, which don’t pay any taxes. It’s way past time for our politicians and health care leadership to focus on cost-effective care and stop the edifice complexes, empire building and money-gouging.

Scott MacKay’s commentary can be heard every Monday on Morning Edition at 6:45 and 8:45 and at 5:44 on All Things Considered. You can also follow his political analysis and reporting at our `On Politics’ blog at RIPR.org