partners healthcare


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


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.



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

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

The CEO Checklist For Better Medical Care

(IOM -- The CEO Checklist)

Checklists are all the rage in medicine these days.

The simple concept — that a short, well-crafted list of basic but critical items can help focus even the most accomplished doctor and improve care — was pioneered by Dr. Peter Pronovost, of Johns Hopkins and popularized by Dr. Atul Gawande, the New Yorker writer and surgeon at Brigham & Women’s Hospital. Gawande wrote about checklists for surgery, among others. And recently, a study came out on an effective, World Health Organization-backed checklist for childbirth.

Today, the Institute of Medicine releases a new paper: A CEO Checklist for High-Value Care , written by 11 hospital chiefs, among them Gary Gottlieb, the president and CEO of Partners HealthCare System, Inc.

But a surgical checklist, which includes things like identifying the patient and surgical site and making sure all the sponges are accounted for after an operation, may be simpler and more practical then establishing a “culture of continuous improvement — commitment to ongoing, real-time learning,” which is #2 on the CEO’s Checklist.

Indeed the IOM paper notes: “The strategies in this Checklist are not, of course, of the “one-and-done” variety. Rather, the items we present here are elements that must become core components of an organization’s DNA.”

But if an institution’s DNA actually does evolve, care improves, according to these CEOs, and costs decline as certain wasteful practices are eliminated.

For instance, the paper notes two examples involving Partners:

1. Partners HealthCare’s Connected Cardiac Care Program (CCCP) is a home monitoring program for heart failure (HF) patients at risk for hospitalization. CCCP’s core components are care coordination, education, and development of self- management skills through the use of telemonitoring. Patients use home monitoring equipment to submit weight, blood pressure, heart rate, and symptoms on a daily basis.
• Better care: 51 percent reduction in HF hospital readmission; 44 percent reduction in non-HF hospital readmission
• Lower costs: More than $10 million in savings to date ($8,155 per patient)

2. Partners participated in a 3-year demonstration project to test strategies to improve the coordination of high-cost Medicare patients. To help primary care physicians manage these patients, case managers were integrated into primary care practices. Case managers developed personal relationships with enrolled patients and worked closely with physicians to help identify gaps in patient care, coordinate providers and services, facilitate communication (especially during transitions), and help educate patients and providers.
• Better care: 20 percent reduction in admissions; 13 percent reduction in ED visits
• Lower costs: $2.65 saved for every $1 spent; 7 percent net savings for each patient in the program

Paul Levy ‘Does The Math,’ Says New Partners Contracts Increase Disparity

Paul Levy of "Not Running A Hospital"

WBUR’s Martha Bebinger had a couple of follow-up questions for Paul Levy, former chief of Beth Israel Deaconess Medical Center and still a widely read blogger who, among a great many other topics, regularly takes Partners HealthCare to task for its high prices.

One of his latest posts discusses Partners’ recent renegotiation of its contracts with Blue Cross and Tufts Health Plan, touted in press releases as saving tens of millions of dollars. He writes that the new contracts will only increase the disparity between Partners’ prices and everyone else’s, and he calculates that over the last decade, Partners has added roughly $2 billion to health care costs paid by Massachusetts businesses and individuals.

Martha asked via email:

1)Why would the disparity between Partners HealthCare System rates and other providers increase under this contract?

2)How do you get the $2 billion figure?

And Paul Levy replied:

Simple math, Martha. Everyone else is getting rate increases of, at most, the same 2-3 percent. Many are getting below that. Since the base for the others was lower than PHS, the spread between the PHS rates and theirs has to be growing. Continue reading

Tufts Health Plan And Partners Renegotiate, Estimate $105M In Savings

Partners: Rethinking care delivery to control costs

WBUR’s Martha Bebinger reports:

The state’s largest hospital network, Partners Health Care, has signed a second contract that trims health care spending. A deal out today with Tufts Health Plan is expected to reduce payments over four years by $105 million dollars: Partners opened an existing contract with Tufts to re-negotiated a lower payment rate.

For Tufts members that means roughly 1% off premium increase they might otherwise see.

Partners CEO Gary Gotlieb says Partners doctors and hospitals realize that rising health care costs are a burden on families, businesses and the government.

“We have to be responsible in looking at that and therefore, we’ll rip up those contracts and look for ways that we can take increases that are smaller over this period of time,” Gottlieb said.

Last year, Partners, which owns Massachusetts General and Brigham and Women’s hospital, agreed to a contract with Blue Cross Blue Shield of Massachusetts, the state’s largest insurer, that will save $240 million. Partners says it is doing its part to relieve the pressure of rising health care costs.

Tufts Health Plan CEO Jim Roosevelt says Partners will also move to a so-called global payment system based on keeping people healthy, not just how many services doctors provide. Continue reading