partners healthcare

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No Court Filing Yet In Partners Deal To Expand

WBUR’s Martha Bebinger reports that a negotiated agreement that would have let Partners HealthCare expand to include South Shore and three other hospitals is on hold.

Partners and Attorney General Martha Coakley had planned to file a deal in court Monday that the AG said would curb Partners’ market clout.

But a spokesman for the AG says “both sides are continuing to negotiate based on the agreement in principle announced last month.”

Massachusetts Attorney General Martha Coakley (Steven Senne/AP/File)

Massachusetts Attorney General Martha Coakley (Steven Senne/AP/File)

The deal would have capped Partners expansion through 2020 after the network, which is already the largest in Massachusetts, was allowed to add the four hospitals and 550 more physicians. Partners had agreed to limit reimbursement increases to the cost of inflation, also through 2020.

But the agreement was criticized by competing hospitals who said it would lead to higher costs. Insurers, consumer groups and employers have asked to review the details before a deal is final. The AG’s office says it expects to allow public comment, although it’s not clear how.

The parties have not set a new date for a filing a final agreement.

Agreement Allows But Limits Partners Growth, Caps Prices To 2020

partners
This just in from the Associated Press:

BOSTON – Attorney General Martha Coakley has reached an agreement with Partners HealthCare, the largest hospital and physicians’ network in Massachusetts, that will allow it to acquire South Shore Hospital and Hallmark Health Systems.
Coakley says the deal will also fundamentally alter the negotiating power of Partners for the next decade and help control health care costs.
Monday’s agreement must be finalized by the parties by June 16 and approved by a court before taking effect.
The deal includes capping health costs at the rate of inflation across the entire Partners network through 2020.

And this from the Health Policy Commission

Attorney General Martha Coakley’s Agreement in Principle with Partners HealthCare

Statement of Dr. Stuart H. Altman, Chair, Massachusetts Health Policy Commission:

“I am pleased the comprehensive settlement described by the Attorney General addresses concerns raised in our recent cost and market impact review report. Our objective, data-driven review, referred to the AG in February, found that the acquisition of South Shore Hospital by Partners HealthCare System will increase health care spending, likely reduce market competition, and result in increased premiums for employers and consumers. I look forward to reviewing a final agreement, but I believe the AG and the parties have taken our work into account in developing the conditions under which this transaction can move forward. The HPC will continue to assess the impact of provider market changes and work with the AG to foster a more competitive health system for the benefit of Massachusetts consumers and businesses.”

A message from Partners Healthcare chief Dr. Gary Gottlieb lays out some details:

Dear Colleagues,

I am writing to share some important news concerning an agreement in principle that Partners HealthCare has reached today with Massachusetts Attorney General Martha Coakley. We have been engaged in discussions with her office related to our mergers with South Shore Hospital (SSH), Hallmark Health System (HHS) and Harbor Medical Associates (HMA). The regulators have also been reviewing our contracts with non-employed physicians to understand the extent of their partnership with us. Continue reading

Restraining Partners? Rampant Speculation On A Deal In The Works

What’s up with that Partners-South Shore deal?

This question has come up in every conversation about hospitals in Massachusetts for the past three to four months, at least.  It’s important because the final resolution will be a benchmark for future hospital mergers, acquisitions and partnerships in Massachusetts and beyond. And it may finally address complaints that Partners Healthcare hospitals and doctors are paid more, in some cases much more, than most of their competitors.

If you’ve (understandably) lost track, here’s a recap:

partnersPartners announced plans to acquire South Shore Hospitals in June 2012.

The state’s Health Policy Commission concluded the deal would increase costs $23-$26 million a year.

Partners countered, saying that adding South Shore to its network, currently the largest in the state, would save $27 million a year.

The commission stuck to its original findings and sent a report to Attorney General Martha Coakley.  She, along with the U.S. Department of Justice, have been looking at whether Partners exploits its size and market clout to drive up health care prices and all of our premiums.

There are lots of theories about why we haven’t heard anything since Coakley acknowledged in March that she was in talks with Partners and South Shore.  Is there an impasse?  Are federal regulators clogging up the works?  What kind of pressure is Coakley (who is also running for governor) facing? I’ve heard all kinds of theories. Feel free to add yours below.

Coakley told the South Shore Chamber of Commerce last week that she expects to complete her review of the deal in a month or two.

Working with the Department of Justice, Coakley could sue to try and block Partners from bringing South Shore into its system.

But a deal that would limit Partners clout seems more likely. So what should it include?

Here’s where my random conversations with doctors, hospital executives and patients gets really interesting. The virtual water cooler chatter includes these possible scenarios:

1. Partners can add South Shore — and that’s it.  No further expansion for, say, five years or so (the time frame varies from three to 10 years). Keep in mind, Partners has already announced plans to acquire two North Shore hospitals after the South Shore deal is done.

2. Partners can add South Shore, but it must sell off another hospital of equivalent size or scope. Continue reading

Partners On Anti-Merger Report: ‘Misleading,’ ‘Flawed,’ ‘Inaccurate’

partners

Partners HealthCare does not hold back in the response it plans to file today with the state’s Health Policy Commission (HPC). The commission issued a report last month that marked a rare effort to crimp Partners’ dominance in the Massachusetts market. The commission said that if Partners adds South Shore Hospital in Weymouth to its growing network, costs will increase around $23-26 million a year.

Wrong, says Partners, in an 89-page rebuttal that includes dozens of letters and testimonials from South Shore area leaders who support the merger. The commission should withdraw its finding, concludes Partners, and not send the proposed merger to the state attorney general for further regulatory review.

Some key points from Partners’ response:

1) The merger would not “add $23-26 million in annual physician health care costs.”

Partners says the HPC doesn’t understand how Partners’ physician contracts work. The assertion that the merger “will result in significant annual physician cost increases is based on material misunderstandings of both the Partners payer contracts and the process and goals of the parties’ proposed physician development efforts” in the South Shore Hospital area.

2) If there are any cost increases, they would be “offset” by better value and more efficient care.
Continue reading

For $9,000, Your Personal Genome Sequenced

Updated at 10:52 AM, August 28th, 2013

If you’ve got $9,000 handy and a hankering to learn more about your genetic roadmap, here’s your chance.

Partners Healthcare, the largest hospital system in Massachusetts, announced yesterday that complete genomic sequencing is now available to patients. The full test would take 16 weeks, said spokesman Rich Copp, and insurance coverage would be determined on a case by case basis.

greyloch/flickr

greyloch/flickr

Formerly a technique limited to the laboratory, complete genome sequencing maps the 3 billion pairs of DNA in a human’s genome. In recent years, scientific and technical advances have made genetic sequencing available for clinical use.

That’s a far cry from 2006, when scientists were still diagnosing a “market failure” in providing “rapid, low-cost medical grade genomes.” It was enough to spur the creation of the Archon Genomics X-Prize, which promised a $10 million prize to a team that could sequence 100 genomes in 30 days for less than $10,000 per genome. The X-Prize team ultimately called off the competition, citing commercial interests making the prize incentive superfluous:

What we realized is that genome sequencing technology is plummeting in cost and increasing in speed independent of our competition. Today, companies can do this for less than $5,000 per genome, in a few days or less – and are moving quickly towards the goals we set for the prize. - Peter Diamandis, chairman of X-Prize Committee

But where, exactly, will your new $9,000 map lead you? Shortly after he was diagnosed with cancer, Steve Jobs spent $100,000 on getting his genome completely sequenced. Continue reading

Rankings: MGH Down From Top Spot To No. 2, McLean Leads In Psych

Last year when the annual hospital rankings by U.S. News and World Report came out, Massachusetts General Hospital ranked No. 1 in the nation and threw itself a party, including a celebratory duck boat parade.

Massachusetts General Hospital is one of the highest paid in the state. (Steven Senne/AP)

Massachusetts General Hospital (Steven Senne/AP)

This year, MGH, a Partners HealthCare hospital, was ranked No. 2 in the country, after Johns Hopkins, according to the just-released U.S. News tally:

Baltimore’s Johns Hopkins Hospital reclaimed the No. 1 spot after last year losing a 21-year reign to Boston’s Massachusetts General Hospital.

As far as we know, there will be no parade this summer.

On the upside, McLean Hospital in Belmont, also under the Partners umbrella, was ranked as the overall best hospital for psychiatry. The region’s dominant health system also operates a number of other hospitals that ranked high on the U.S. News list, according to a news release:

Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital (BWH), the founders of Partners HealthCare, rank among the nation’s top ten hospitals on the U.S. News & World Report annual Honor Roll of America’s Best Hospitalsfor the seventh consecutive year. MGH ranked second in the nation and BWH ranked ninth. Continue reading

Mapping The Ever-Shifting Mass. Hospital Landscape

Thanks to health policy guru John McDonough for highlighting the Blue Cross Blue Shield of Massachusetts’ new Health Care Delivery System Map which offers a snapshot of the state’s medical industrial complex as it becomes increasingly concentrated. There’s great data here, and it’s fairly easy to sort, from hospital revenue, ownership and geography to the latest info on mergers, acquisitions and new partnerships.

This online, interactive site won’t tell you where to get the best colonoscopy or most specialized cancer care, for instance, but it does offer insight into the scope and breadth of the marketplace. It essentially provides a baseline view of the state-of-the-industry for all the Mass. hospitals and hospital systems, medical groups, doctor networks and community health centers.

(Blue Cross Blue Shield Foundation of Massachusetts)

(Blue Cross Blue Shield Foundation of Massachusetts)

As McDonough writes:

For example, if you want to begin to understand why Partners Healthcare is so dominant in the state’s healthcare market, don’t go to this page, Hospital Systems by Size, on which Partners is #2 after Steward Health Care System. Go this this page: Physician Networks and Major Medical Groups, where the size of Partners’ physician network (called Partners Community Healthcare Inc., PCHI, or “peachy”) is larger than #2 (Steward) or #3 (Atrius), combined.

Or look at hospitals by Net Patient Service Revenue, and see that Partners total NPSR in 2010 ($4.2 billion) was the same as #s 2 (UMass Memorial), 3 (Steward), and 4 (Beth Israel Deaconess) combined.

Don’t forget this helpful page of Recent Changes in the Massachusetts health care market.

Readers, please roam around the site and let us know what’s interesting or useful to you.

It’s Time To Pay Up For Mass. Health Costs Law

By Martha Bebinger
WBUR

Guess who has to write the state a check for the lion’s share of funding for the newish health costs law?  Almost half the money will come from Partners Healthcare and Blue Cross Blue Shield of Massachusetts (see the charts below).

A little background: The law that’s supposed to improve health care quality quality and control costs also imposes a hefty fee on some hospitals and insurers (as well as some other “payers”). The law says the surcharge will raise $225 million for distressed hospitals, a prevention fund, electronic medical records and the agency that will bring the law to life.

Now we have the first drafts of who will pay and how much.  Among hospitals, only the Partners system, Caregroup (bet you haven’t thought of this organization for a while) and Children’s meet the criteria for the fee (the criteria are spelled out in draft regs at the bottom of this page). Partners took a $42mil charge, in anticipation, last year. Caregroup and Children’s have told the state they may ask for a reduction, claiming they don’t fit the criteria.

  1. Partners Healthcare – $42 million
  2. Caregroup – $11m
  3. Children’s – $8m

Now the insurers. Here’s the full list of 96 payors and their proposed fees. The top five are:

  1. Blue Cross Blue Shield of MA – $65m
  2. Harvard Pilgrim Health Care – $21m
  3. United Healthcare – $9m
  4. BMC HealthNet Plan – $7m
  5.  Neighborhood Health Plan – $7m

By the way, the law says insurers can’t increase premiums to cover this surcharge. Continue reading

Commentary: What We Learned From Cutting Colon Surgery Infections

costs of  complications

(Courtesy of MH)

By Matthew Hutter, MD
Guest Contributor

Dr. Matthew Hutter is director of the Codman Center for Clinical Effectiveness in Surgery, and a surgeon at Massachusetts General Hospital. This post is adapted from a talk he just gave at the American College of Surgeons’ Surgical Health Care Quality Forum in Boston.

Surgery to remove part of the colon is prone to nasty complications nearly one-third of the time. Even though the colon can be rinsed, it is never really “clean,” and so the procedure is prone to infection that can lead to open wounds. Other complications include abscess, bowel obstruction, pneumonia and worse. Sometimes, people die.

Dr. Matthew Hutter

Dr. Matthew Hutter

This high rate of complications is one reason why our quality consortium – five Partners Healthcare hospitals – chose partial colectomy as our first target for improving patient outcomes. Although our collective 29-percent complications rate was lower than the national average, we thought it could get still better.

It did. Over one year, we cut our complication rate by a dramatic 23 percent. How? Please read on for the lessons we learned about how to improve quality and save money at the same time — lessons we think may be broadly applied across surgery. Continue reading

Partners Moves A Step Closer To Taking Over South Shore Hospital

Against a backdrop of fast-moving hospital consolidations in the state, Partners HealthCare today announced it’s taking “a formal step” toward scooping up South Shore Hospital, in South Weymouth, as part of its high-powered network of hospitals.

Here’s part of the statement on the South Shore Hospital web site:

Partners HealthCare, Brigham and Women’s Hospital and South Shore Hospital have taken a formal step toward South Shore becoming part of Partners to fulfill a vision to improve the coordination, accessibility and affordability of quality health care for patients in Southeastern Massachusetts. The non-profit organizations have entered into a memorandum of understanding in which South Shore Hospital would become a member of Partners HealthCare. Continue reading