Are two big #hospital groups better than one? #consolidation

At Wednesday’s meeting, the  Massachusetts Health Policy Commission heard a staff report on the proposed merger of Beth Israel Deaconess Medical Center

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From the report. AMC= academic medical center

 In summary, we find that these transactions are anticipated to increase market concentration, solidify BIDCO’s position as the second largest hospital network in the state, and could strengthen BIDCO’s ability to leverage higher prices and other favorable contract terms. However, BIDCO’s market share will remain far smaller than the dominant system in the state for most services.

Member of the commission pondered the impact of having two large hospital systems, instead of just one giant one — Partners. Their conclusion — no one really knows, but it would be worth finding out.  We’ll see where that goes.

From the Globe:

“… commissioners noted that the growth of Beth Israel Deaconess Medical Center and Beth Israel Deaconess Care Organization, or BIDCO, could be a good thing. BIDCO is a network of affiliated doctors and hospitals that negotiates contracts with insurers and gives its members set budgets under which to manage patient care.

“To me, big is not necessarily bad,” said Marylou Sudders, the state secretary of health and human services, who sits on the commission. “Shouldn’t Massachusetts have… a strong competitor to what is the largest and most expensive health system?”

The commission said that by adding MetroWest and the Baptist to its network, BIDCO will solidify its place as the state’s second largest provider network. But it will remain much smaller than Partners, with about 13 percent of all hospital discharges, compared to 29 percent for Partners.

 

Looking for Boston Globe health reporting? Try the business section

ssUPDATE: Props to Beta Boston, another source of Globe health reporting.

Since the Globe currently has no full-time health and science editor, no science writer and a hard-to-find, often dated health site, we turn to the business section for news on health, or at least health finance and pharma. Perhaps things will pick up in the fall.

In terms of Globe-ish  health-sci-ish  reporting, we see STAT continuing to pop up in the paper and the paper’s website but not the STAT website. The business section of the print version of today’s paper premieres a weekly column called Kendall Squared. Today, Andrew Joseph reports on the rebranding of the square-less square, the sale of dishes at the closed Hungry Mother restaurant, a Forsyth Institute dentist who runs a children’s clinic in Kuwait and a non-profit dispute resolution group that is being prices out of the Square.

In the meantime, best to follow individual members of the Globe‘s shrinking but solid Metro sci-health team:

Kay Lazar @GlobeKayLazar

Liz Kowalcyk @GlobeLizK

Felice J. Freyer @felicejfreyer

And, check the business page. The state Center for Health Information and Analysis has come out with it’s latest hospital profits report and today, The Globe helps sort it out for us.

The state’s biggest hospitals were the most profitable in 2014, with Massachusetts General Hospital, the largest academic medical center, earning $200 million, up 34 percent from the previous year, and Brigham and Women’s Hospital earning $152 million, up 9 percent. Both are owned by Partners HealthCare of Boston.

Other big earners were Baystate Medical Center of Springfield, Lahey Hospital and Medical Center in Burlington, Saint Vincent Hospital in Worcester, and Beth Israel Deaconess Medical Center in Boston. The results are for fiscal year 2014, which for most hospitals ended last September.

The profits overall, however, mask some of the struggles in the changing field. Quincy Medical Center lost $39 million last year, the most in the state. Its owner, Steward Health Care System, closed the hospital at the end of the year. North Adams Regional Hospital in the Berkshires closed several months earlier. The push to cut costs has, in part, prompted several hospitals to consider mergers or acquisitions.

Earlier this week, the paper reported that the advent of ACOs has cut Medicare spending at five major health systems in the state

New figures show five Massachusetts health systems saved a combined $141 million during that period as part of the program, which aims to rein in costs by better coordinating care for Medicare patients and cutting unnecessary hospital stays and medical services. Doctors manage care for these patients in pools known as Pioneer accountable care organizations.

Are Facebook rankings of hospitals accurate? Two studies say yes

From Health Leaders Media:

childrens-facebookIn the era of the engaged patient, consumers shop around for healthcare services. When it comes to hospitals, they could consult several ratings programs for information on readmissions and hospital-acquired infection rates.

But data shows they don’t do so in big numbers.

One reason may be that quality measures familiar to providers may mean little to patients. Now, a study suggests that healthcare consumers may be able to find reliable data on hospitals quality in a familiar place – Facebook.

A Massachusetts General Hospital study has found that hospitals with lower 30-day readmissions rates have higher ratings on Facebook than hospitals with high readmission rates.

“The potential impact of social media ratings on healthcare consumer decision-making must not be underestimated in this changing healthcare environment,” say the authors of a study published online by the Journal of General Internal Medicine.

If you can’t join them, beat them: BIDMC in takes over Milton hospital

When the Harvard hospitals decided to join forces as Partners, they cut BIDMC out of the deal. So, this story from the Globe  – on Beth Israel Deaconess Hospital-Milton –is worth noting:

partnersdownloadConsolidation in the health care industry has been viewed with suspicion, leaving critics worried that the state’s biggest health care networks want to leverage increased market power into higher rates. Partners HealthCare, the largest health care system in Massachusetts, recently abandoned its bid to acquire South Shore Hospital in Weymouth in the face of such criticism and a ruling from a judge who said Partners’ growth would raise costs for consumers.

…The Milton case shows how consolidation — though it often increases costs to consumers — can also offer a lifeline to a struggling hospital. The brand alone of a big Boston health care network can be a powerful force, analysts said.

 

Hospitals consolidation: Brill says yes, new Massachusetts AG says no

From Shirley Leung’s Monday column in the Globe:

partnersNo judge or jury delivered a verdict on the Partners HealthCare settlement Monday, but we didn’t need either after Attorney General Maura Healey’s three-page court filing.

She thinks the deal stinks, and if given the chance, she would bring an antitrust suit to block Partners’ efforts to expand. And just like that, the 43-year-old rising political star dared to rock the biggest boat in Massachusetts health care. In the wake of her threat, Healey left a list of winners and losers.

From Steven Syre’s column in today’s Globe:

Maura Healey has been on the job less than a week, but we don’t have to wonder where she stands on the biggest health care conflict in Massachusetts.

And, a Q. & A. from Steven Brill, author of “America’s Bitter Pill: Money, Politics, Backroom Deals and the Fight to Fix Our Broken Health System. That book looks at focuses on the debate over the Patient Protection and Affordable Care Act. But it also returns to Brill’s indictment of high hospitals costs that filled an entire issue Time magazine in 2013. His solution looks very much like a combination of the Kaiser Permanente insurer-plus-provider approach and the Partners’ plan.

HLM: Why will this consolidation approach work to curb costs where other reforms have failed?

Brill: The reason this idea may work is it is going to happen without my writing about it. It’s going to happen. The question is, do we seize that momentum, turn it around jujitsu- style and attach a whole bunch of regulations to it?

I really started thinking about this after my [heart] surgery. I decided: New York Presbyterian, it’s a damn good place and the guy who runs it is a good guy. [Later] I was watching a panel including Toby Cosgove [CEO of Cleveland Clinic] and someone said: You’re gobbling up Cleveland and your market share is way too high.

Cosgrove said, the FTC would never let us have too much of a market share. I’m thinking, this guy Cosgrove, he’s a celebrated surgeon, a war hero. He seems like a pretty good guy to me. The idea the he wants to control and provide healthcare all over Ohio, why is that such a bad thing?partners-logopartners-logo

New Mass. electronic health records grants: Wiring Healthcare for the Homeless

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Click for larger map.

From Healthcare IT News:

The Massachusetts eHealth Institute at the Massachusetts Technology Collaborative will give 32 collaborative projects up to $75,000 each in HIway Implementation Grants to help 80 healthcare organizations across the Commonwealth connect to the HIway, Massachusetts’ statewide health information exchange.

From the Massachusetts eHealth Institute

Recipients were awarded grants based on their ability to build upon existing improvement efforts that impact care quality, costs or population health. Types of collaborative projects receiving funding include:

  • A large facility using the HIway to manage heart failure patient care;
  • Coordination between care facilities and patient care coordinators;
  • An ambulance service using the HIway for pre-hospital care coordination for the homeless; and
  • An acute care organization using the HIway to share discharge summaries to skilled nursing facilities and home health organizations.

Globe: For-profit hospitals in low-income communities want a cut of high fees paid to competitors #healthcarecosts

It is well documented that some Massachusetts hospitals –– read Partners — have the bargaining power to  extract higher pay rates from the feds and private payers.  Today’s Globe offers two takes on the ongoing battles.

This one is behind the paywall: 

images stewardA new coalition led by the state’s biggest health care company and its largest health care union will be pressing for higher payments to community and safety-net hospitals, saying patient care is threatened by a widening gulf between health care in rich and poor areas.

The group, calling itself the Massachusetts Healthcare Equality and Affordability League, will be formally launched Thursday by Steward Health Care System, a for-profit cluster of community hospitals, and Local 1199 of the Service Employees International Union, which represents more than 47,000 workers at sites that care for blue-collar and low-income patients.

And while it would not the odd to hear heated rhetoric from 1199, the story quote Steward’s chief executive, Ralph de la Torre, calling the disparity  “socioeconomic bias and bigotry.”

More on de la Torre in this Globe magazine profile. 

During his career, the 44-year-old heart surgeon-turned-hospital executive has shown himself to be a brilliant maestro, time and again using his relentlessness, charm, vision, and opportunism to turn an array of opponents into a symphony of supporters.

His most recent symphony was his most impressive work. As CEO of the Caritas Christi hospital network, he pushed through an $895 million deal late last year that took a group of community hospitals founded primarily by nuns to care for the poor and put them in the hands of the New York private equity giant Cerberus, a firm that takes its name from the mythical three-headed dog guarding the gates of Hades. To steer the deal through, he orchestrated an unlikely alliance of the Boston Archdiocese, Democratic elected officials, the Service Employees International Union (SEIU), and community organizers in some of the state’s poorest cities – all to support turning the struggling nonprofit hospital chain into a for-profit operation owned by a group of high-flying financiers

And an editorial calling for a correction to high rates driven by a formula designed for struggling rural hospitals. The state’s only technically rural hospitals is in tony Nantucket.

SINCE 2010, Massachusetts hospitals have benefited from an annual bonus in Medicare funding of at least $250 million. Congress is expected to vote to eliminate this windfall in early June, a blow to local hospitals, which may face layoffs and cuts in patient care as a result. But as the system is set up now, the state receives these funds due to a loophole in the national health reform law and at the expense of at least 40 other states. It’s time to find a more sustainable and equitable way to support top-notch medical care.