Governor questions Boston role with RI hospitals

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In an interview while visiting the Warwick Emergency Operations Center during Tuesday’s storm, Gov. Gina Raimondo applauded talks between Lifespan and Care New England but had reservations over whether Partners HealthCare of Boston should be at the table.

She questioned whether an arrangement including Partners, as the three health care providers are exploring, would drive up the cost of health care and have Rhode Islanders leaving the state for care in Boston. If that were the case she fears the state would lose jobs as well as good local health care options.

The governor’s comments come at a time when health care providers are under financial stress and are exploring efficiencies through mergers, acquisitions and partnerships. A brief two-sentence joint announcement by CNE, Lifespan and Partners last month that the parties were having discussions came as a surprise to many, especially since CNE and Lifespan had broken off talks and CNE and Partners had signed a letter of intent to consider CNE’s acquisition by Partners.

A spokesman for CNE said Wednesday there are no new developments to report regarding talks. He would not confirm or deny that talks have commenced.

The development spurred the introduction of legislation that would place stipulations on a health care provider in an adjoining state seeking to acquire a Rhode Island hospital or health care provider.

“We have never seen a proposal where one of Rhode Island’s largest hospital systems would be acquired by a hospital network that is located in a state adjacent to Rhode Island. The potential for patients, jobs and services to migrate to Massachusetts is a serious concern,” said Senator Louis DiPalma, sponsor of legislation that is introduced in the House by Rep. Kenneth Marshall.

Among other things, the legislation, if approved, would require the Department of Health to consider whether the merger or acquisition of systems would impact the number of Rhode Island health care jobs, insurance premiums, migration of patients, funding for medical research and cost of the state’s Medicaid program.

In this case, Raimondo asks whether having Rhode Islanders commute to Boston for health care “is the right thing for Rhode Islanders.” She knows of the relationship Kent Hospital has with Brigham and Women’s, a Partners hospital, finds that working and thinks that could be an indicator of how the parties could work together. Yet, she also has concerns over the viability of CNE that closed Memorial Hospital in Pawtucket because of such a low hospital census.

“Care New England has financial challenges. That’s real and it’s worrisome,” Raimondo said.

The joint announcement of discussions was welcomed by Dr. Al Puerini, president of the Rhode Island Primary Care Physicians Corporation, and brought guarded optimism from the United Nurses and Allied Professionals and a suggestion that the state needs to develop a health care plan from Neil Steinberg, executive director of the Rhode Island Foundation.

In a recent interview at the Warwick Beacon, Steinberg said, “The big issue that we’re missing is that we don’t have a health care plan for the state of Rhode Island, we haven’t had one in decades. There’s no healthcare plan for the state of Rhode Island.”

Without a health plan for the state, Steinberg said it is difficult to judge what might be best for the state. Further, he notes, it’s not limited to Lifespan and CNE. He pointed to talks between South County Hospital and Yale University that apparently have broken off.

“So it’s difficult to judge these things, is this what we’ve planned, is this part of the plan?” Steinberg asks.

Steinberg said the foundation is an advocate of a state health plan and would facilitate such an effort.

“We could fund a consultant that comes in and takes a look at it and there are other models – Maryland has an interesting model – depends how broad you want it, it’s not just hospitals but it’s going on in technology in healthcare. What do people really need and want. A lot of these things, if we took out a blank piece of paper and designed almost anything – healthcare, education – it wouldn’t look like it does today,” he said.

Raimondo was not aware of Steinberg’s proposal.

Puerini has talked with Steinberg. He called a state health care plan “sort of the obvious answer.”

He feels the talks between the three health care providers has “lots of potential” for Rhode Island. In an op-ed, which was published in the Providence Journal and appears in today’s Beacon, he writes, “The possibility of CNE, Partners and Lifespan collaborating, sharing resources and working together on all aspects of patient care could be the best thing that has ever happened to health care in our state.”

Earlier attempts to bring Lifespan and CNE together have gone nowhere. With the disclosure last year of talks between Partners and CNE, Brown University President Ruth Stimson released a letter that the university was talking with Prospect Medical Holdings, a for-profit health care provider based in California, who she thought would be better suited to run CNE.

Puerini viewed Brown’s action as an effort to protect its interests.

Observing that health care providers are vying for market share, he said, “We also have the Ivy League colleges in competition.” He noted Partners’ relationship with Harvard University.

“It’s a crazy atmosphere,” he said, “there’s so much potential.”

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