CNE/Partners deal critical for health care, facilities, says Fanale

By JOHN HOWELL
Posted 4/25/19

By JOHN HOWELL Kent Hospital could use a facelift, and that would be one outcome if the state were to approve the acquisition of Care New England by Partners HealthCare of Boston, CNE president Dr. James Finale said in an interview Thursday at Beacon

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CNE/Partners deal critical for health care, facilities, says Fanale

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Kent Hospital could use a facelift, and that would be one outcome if the state were to approve the acquisition of Care New England by Partners HealthCare of Boston, CNE president Dr. James Fanale said in an interview Thursday at Beacon Communication offices.

Fanale was joined by Dr. Betsy Nabel, president of Brigham Health, and Dr. Chester Hedgepath III, head of cardiology at CNE to give Beacon editorial staff members an opportunity to ask questions about the acquisition, which will be reviewed by the Department of Health and the Attorney General once they deem the application complete.

The acquisition has been criticized by Lifespan president Timothy Babineau as not in the state’s best interests, partially on the basis that Rhode Island patients would be diverted to Partners’ facilities, of which Brigham’s is one, to the detriment of Rhode Island hospitals.

Even further, Lifespan launched a comprehensive campaign on Wednesday, with its own website – ProtectRIhealthcare.org – that goes into great detail about their concerns, which claim the merger would lead to higher costs for Rhode Island patients, decrease quality of care, cost Rhode Islanders jobs and limit the ability for Rhode Islanders to make their own decisions about which care facilities they choose to utilize.

The campaign alleges that an alternative partnership between Care New England, Lifespan and Brown University would lead to the best result for Rhode Island.

Fanale and Nabel said discussions with Lifespan are also being held, although such a further expansion of Partners would not be actively pursued until, and if, the Care NE acquisition is completed.

In stark contrast to the criticism, Fanale portrayed the Partners acquisition as the best outcome for patients, the Care NE staff and the state’s medical facilities.

“We at Care New England, Kent and our other entities looked at this as a chance to improve the care that we deliver to our patients. That’s what it’s about,” he said.

Fanale spoke about the nearly decade-long clinical affiliation Kent Hospital has had with Brigham in the operation of its cardiac care labs and how, from experience, patients are not being diverted to Brigham. He thought that, at best, one of 31 cardiac patients is referred to a Partners Massachusetts hospital and that would be only for a specialized procedure.

Hedgepath said Brigham has enabled Kent to get its cardiac angioplasty labs fully up and running so they are now performing about 400 non-emergency and 100 emergency procedures annually, saving precious minutes for Kent and South County patients suffering from a heart attack who would otherwise be transported to Rhode Island or Miriam Hospitals in Providence.

As Partner hospitals, Fanale said Kent as well as Women & Infants’ and Butler hospitals that are all part of Care NE could expand the programs and services offered patients.

In a surprising assessment of the condition of hospitals operated by Care NE, Fanale said CNE has “been under-capitalized for years.”

“You’ve been in the Kent building and I would say it’s a little tired,” he said. “This enables us to have access to capital, whereas right now we don’t have access to capital. With this agreement we’ll be able to begin to fix our infrastructure. I say that although the building itself does not provide quality care, we owe it to our patients to have a facility that has rooms that are modern, that has bathrooms in every room – and at Kent we don’t have that.”

Is Partners prepared to underwrite those capital costs?

“We’re at the planning stages right now of being proactive. We’re doing an assessment of what the capital needs are, and then we’ll develop a plan around that. We anticipate that plan will be part of our conversation with the regulatory agencies,” Nabel said.

A point she stressed is should the acquisition gain approval, funds contributed to Kent and other CNE hospitals would remain with those institutions.

“We’ve got charitable assets and funds and restricted funds at every hospital…We have to review all of that, we have to provide all of that to the AG to make sure he’s assured those charitable assets will remain. Part of this whole process, too, is that all funds that are raised at those hospitals stay at the individual hospitals,” she said.

Fanale and Nabel said they have had recent discussions with Lifespan, although nothing is likely to come of them soon.

“We’ve been advised to go slow and incremental, so we’re proceeding with the acquisition of Care New England,” Nabel said.

“If you brought Lifespan and Care New England together in the state, you enter into significant anti-trust issues. That would take a lot of time with the Federal Trade Commission with no assurances that it would ever be approved. Furthermore, if you look at both Care New England and Lifespan, they are both under-capitalized and really don’t have the funds to re-capitalize each other,” she said.

Attorney General Peter Neronha concurred a merger of Lifespan and CNE would likely raise anti-trust questions, as it would be a combination of the largest and second largest health care systems in the state. The Partners acquisition is different.

“Anti-trust is a potential issue whenever there is a consolidation. What makes this one a little bit different is this is an out-of-state entity purchasing an in-state entity, which does not have the whole market. I guess I would say anti-trust is less of an obvious issue here, but it’s a consideration we would take in any consolidation,” he said.

He described his role in the process as looking at conflicts of interest and charitable assets and that of the Department of Health as evaluating accessibility, affordability and quality of care.

What Neronha finds missing is a state health care strategy, which he said is under study by the Rhode Island Foundation.

“We haven’t had a written health care strategy since 1989, and I think we could use one. Long-term, I’d like to be part of those conversations,” he said.

Joseph Wendelken, spokesman for the Department of Health, said the department is in the process of requesting additional information about the acquisition and when that is deemed complete the clock will start ticking. Both the AG and DOH have 90 days to review the proposal. The process will include public hearings.

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