1/16/2024 0 Comments Butler health system mergerInstead, Partners became a price-taking monolith that leaves our two biggest hospitals as each other’s main competitors. Partners has had an uninterrupted ride since Massachusetts General and Brigham & Women’s hospitals affiliated in 1994, a deal that originally promised to cut costs, merge services, and become one system. A key question is, would Massachusetts would be better off with two Partners rather than one? Officials disagree. Third, some state officials wonder whether stopping BILH is the right thing to do. (Though the Health Policy Commission is empowered to evaluate mergers and acquisitions and refer to the AG, they lack enforcement power.) The BILH deal exposes a regulatory gap that should be evaluated and addressed by the Legislature. Attorney General Maura Healey can fight violations of anti-trust, public charities, consumer protection, and other laws and is not confident she can use these tools to block BILH as she did to Partners’ 2014 proposal to absorb South Shore Hospital and Hallmark Health System. The Department of Public Health, through its Public Health Council and Determination of Need process, believes it lacks authority to reject proposed mergers and acquisitions because of cost concerns. Second, the two state agencies with oversight authority are now seeking an agreement with BILH parties on conditions that would accompany the merger because these officials are not confident they possess necessary legal tools to stop it. If approved, BILH would remain a system, like its predecessor hospitals and like Partners, that draws patients and money primarily from white, affluent communities, not disadvantaged, poorer and MassHealth dependent communities. The merger would transform them into economic rivals to the state’s unchallenged medical care behemoth, Partners HealthCare. On average, BILH institutions today are moderately priced health systems. I want to examine the larger picture.įirst, BILH would have a large and negative impacts on health care cost control in Massachusetts without improvements in access for vulnerable communities or in higher quality. My colleague, Paul Hattis, recently provided a helpful commentary in CommonWealth on ways to mitigate the impact of the BILH merger. In this commentary, I consider the implications of the BILH proposal based on review of key reports and conversations with key players. Also last week, the health commission reported on the projected annual costs of Question 1, the November Massachusetts ballot initiative that would set statutory nurse-patient ratios in all acute care hospitals – estimating $679 to $949 million in new annual costs in our $61.1 billion state health system. They estimate $158.2 to $230.5 million in added annual costs above current projections from this deal. Last week, the state’s Health Policy Commission released its final analysis of the cost, quality, and access impacts of the merger. The current controversy over the proposed merger of Beth Israel Deaconess Medical Center, Lahey Health, and other hospitals and physician organizations into “Beth Israel Lahey Health” (BILH) brings into sharp relief underlying systemic problems that are getting worse, not better. And self-congratulations can obscure lingering and insidious system weaknesses. Still, history teaches that these trends can turn downward on a dime. As Michael Widmer noted in his October 7 Upload piece, over the past five or so years, even the state’s performance on controlling costs has also been a national standout. Recent national surveys on cost, quality, access, and public health from the Commonwealth Fund, the United Health Care Foundation and others show the Bay State to be best or among them. Since passage of the 2006 universal health insurance law, we’ve been tops in having the lowest number of uninsured the nation. FOR THE BETTER part of this decade, Massachusetts had been on a roll regarding its health system’s performance.
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