Governor brings health systems to table, Partners bows out

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After months of trading different perspectives on the future of Rhode Island health systems – often laced with dire predictions that Rhode Islanders could face more costly and vastly diminished services – Gov. Gina M. Raimondo has asked Lifespan, Care New England and Brown University to resume negotiations to determine whether they can come to an agreement that would create a locally-run, academic medical center in Rhode Island.

Partners HealthCare, meanwhile, has for now withdrawn its bid to acquire Care New England. CNE, which is secondary in size to Lifespan, operates Kent, Women and Infants and Butler hospitals.

The announcement came as a surprise, as it appeared Partners and CNE were in the throes of finalizing an agreement that would need approval from the Rhode Island Department of Health and the attorney general’s office.

While Kent Hospital has had a decade of working with Brigham Health, a member of the Partners system, during which a minority of patients have been referred to hospitals in the Partners systems for treatment, Lifespan argued that is the acquisition happened Rhode Island patients would be sent to Massachusetts, thereby inconveniencing people and driving up costs. Additionally, Lifespan argued Rhode Island physicians – especially those in specialized procedures and fields – would lose patients, eventually forcing them to leave the state.

Lifespan splashed its point that Rhode Islanders would suffer from the competition using advertisements, a website, opinion pieces and in a petition signed by scores of Rhode Island physicians, while CNE took a less visible course with the occasional op-ed piece and responding to, rather than initiating, the public discourse.

Tuesday’s announcement by the governor was carefully orchestrated so as not to come as a shock to CNE employees and community leaders.

A memo went out to all CNE staff at 9:50 a.m. that Raimondo would make an announcement that morning to bring CNE, Lifespan and Brown University together.

“Let me assure you,” CNE President Dr. James Fanale wrote, “that the work we have done to date in regard to our planning with Brigham Health will serve to further strengthen our relationship and grow our clinical affiliation.” He said he is confident there is still a “great opportunity to collaborate with Partners/Brigham Health within the Rhode Island health care landscape.”

In her statement, Raimondo said a “thriving hospital system is critical to the health care of all Rhode Islanders.”

She said she had heard from a number of stakeholders over the last several months and understands the appeal of a locally run, academic medical center in the state.

“With that in mind, I have called on Care New England, Lifespan and Brown to sit down once again and consider a joint solution. While I have little control over private hospital systems, I do have the ability to bring these parties together and ask them to reconvene negotiations on a crucial decision that will impact all Rhode Islanders for decades,” she said in a statement.

The release was accompanied by a statement from Anne Klibanski, M.D., interim president and CEO of Partners HealthCare.

“In order to give this effort the best possible chance for success and to provide maximum flexibility to the governor and the leadership of these three institutions, we will be withdrawing our application to acquire CNE,” her statement reads. “We look forward to reengaging at the appropriate time – especially with a fully integrated local system. We greatly value our relationship in Rhode Island and want to do what’s best for the state and its citizens.”

Putting their seal of approval on the arrangement were Timothy J. Babineau, M.D., president and chief executive officer of Lifespan, and Lawrence Aubin, chair of Lifespan’s board of directors.

“We are pleased that the governor has taken this important first step to achieve a vision that has eluded the state for more than two decades,” their joint statement reads. “We are confident that with the good faith efforts of all the parties involved, we will finally achieve the vision of unified academic health care system for the state of Rhode Island that will have a positive impact on patient care and our economy for years to come. We are excited to get this effort underway.”

While earlier efforts to merge CNE and Lifespan have failed, Finale said, “Care New England is committed to providing the best health care possible throughout the state. We appreciate the governor’s dedication and commitment, and respect the importance of a possible Rhode Island solution involving CNE, Lifespan and Brown University. To that end, we have agreed to further explore the feasibility of this option and will begin discussions in earnest immediately because it is simply too important for Rhode Island’s future.”

The Rhode Island Foundation and its president and CEO, Neil Steinberg, and Brown President Christina Paxson also weighed in on the prospect of the talks.

“I look forward to these discussions, and I hope we can develop the beginnings of a framework that will serve the best interests of Rhode Islanders for years to come,” Paxson said.

“We’ve supported the concept for some time, in alignment with the foundation’s strategic focus on improving the health of our state’s residents, and we’re glad to provide resources to this effort,” Steinberg said.

During the courtship phase of the proposed Partners acquisition of CNE, it was suggested more than once by Lifespan and community leaders that a Lifespan/CNE merger would be the best way to go. Asked in an April 18 interview what he thought of such a merger, Attorney General Peter Neronha said it would raise antitrust issues.

Asked Wednesday if the governor’s proposal raises similar concerns, a spokeswoman for his office emailed: “When and if another proposed health care transaction subject to the HCA is submitted to this office for approval, we will review that transaction in accordance with the act and other applicable statutes within the jurisdiction of this office, including any antitrust considerations. As the attorney general has said in the past, antitrust is a potential issue whenever there is a consolidation and the office would evaluate it accordingly.”

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