“Failure of Health Policy in RI” - Former Director of Health on Care New England - Partners Merger

Thursday, April 27, 2017


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Dr. Michael Fine

Former Rhode Island Director of Health Michael Fine called Care New England’s exploration of a merger with Boston-based Partners Health Care a “failure” on the part of Rhode Island on Wednesday.
“I think my reaction is [this] represents in a certain way, the failure of health policy in Rhode Island,” said Fine.


Fine made the comments during GoLocal LIVE with Kate Nagle, and spoke to what he thinks the state needs to do to have a viable healthcare industry.

On the Record

“What we need to do is get to a healthcare system that’s the right size, that takes care of people effectively, efficiently, and affordably,” said Fine. 

“To me, this merger means more cost, and less efficiency. It means more cost, because Partners is a very expensive institution, and I think that they have the ability to use their market power to drive [up] costs somewhat, which is dangerous for the state,” added Fine.

Fine offered what he believes is a more viable healthcare structure in Rhode Island.

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“What we need to do as a state isn’t to maintain hospitals, but to shrink them,” said Fine. “We probably need to close two, or three, or four hospitals if we’re going to get to right size.  And there’s no political appetite for doing so, which is our challenge. What we really need to do is find a way to reduce costs so that healthcare in Rhode Island more affordable than healthcare in Massachusetts and Connecticut, and we haven’t done anything to get us there.

“It’s feasible from a healthcare perspective but in Rhode Island it’s difficult as heck from a political perspective,” said Fine. “We need to look at ourselves and ask why we can’t do what’s in the best interest of the public. It’s clearly in hospitals’ interest to force you into using their services.”

Latest in Healthcare News

The Care New England Health System announced Tuesday that it is implementing “additional staff restructuring as a result of ongoing financial challenges,” with the majority of the reductions taking place at Women & Infants Hospital. 

Butler, Kent hospitals and VNA will also be impacted by the reductions. 

“We are in the midst of enormous change in healthcare in Rhode Island and across the nation. Although extremely painful, these actions are intended to improve our ability to serve our patients well into the future as we react to the continuing shift in the landscape of health care," said Drs. Lawrence Price, President, Butler Hospital and Michael Dacey, President, Kent Hospital, and Kathleen Peirce, vice president of operations, executive director and chief nursing officer, VNA of CNE.


Related Slideshow: 7 Implications and Unintended Consequences of a Care New England and Partners Merger

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Providence does not usually do well in mergers

Remember Providence Gas, Fleet Bank, and Narragansett Electric?

Big employers, deep community involvement, and significant charitable donors — all were consumed and in each case, the number of employees left in Rhode Island by the succeeding company is a fraction of the once independent venture.

To the victor goes the spoils.

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As if the Boston economy isn't good enough, and the Providence economy couldn't be more stagnant

The cityscape of Boston is littered with cranes. Boston Business Journal maps the construction projects utilizing cranes in Boston (see image) and the number of projects is staggering. 

In Providence, there few construction projects and not a crane to be seen. The last thing Providence needs is for another one of its largest employers to be merged into a Boston mega-organization. The likelihood is that jobs will be lost or consolidated to Boston - basic functions like purchasing, accounting, etc. will be lost. 

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Harvard beats Brown in Ivy League match-up

Harvard Medical School is ranked as the #1 research-based institution in America by U.S. News and World Report.

Partners Healthcare’s academic partner is Harvard.

In contrast, Care New England’s academic affiliation is with the Warren Alpert Medical School of Brown University. Brown’s best ranking is 21st for primary care - and is ranked for research way back at #31.

One of the biggest losers in the merger could be Brown's medical school.

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Care New England is RI’s 2nd largest employer, so what will It be in 2 Years?

According to the RI Department of Labor and Training, Care New England is Rhode Island’s second largest employer.

Lifespan is the largest: 12,050

Care New England: 8,500

CVS: 7,800

Cities like "Meds and Eds" (the medical and educational business segments), but Providence and all of Rhode Island is likely to lose high paid, highly educated jobs as a result of this deal.

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Care New England Continues to Struggle

Despite hopes that closing Memorial Hospital would solve the financially beleaguered Care New England's economic woes, new financial documents unveil that CNE continues to struggle.

Additionally, the pursuer - Partners HealthCare - is also making cuts. The Boston Globe unveiled the Partners is cutting about 100 of the company’s tech workers that their jobs were being outsourced to India to cut costs.

“Many of the employees have worked for Partners for several years, or even decades, and are struggling with the company’s decision. Almost all are coders — people who scour patients’ medical records to pinpoint billable services — and earn upward of $40 an hour. Coders in India earn a fraction of that amount, making overseas coding an attractive way for hospitals to cut costs,” wrote the Boston Globe.

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Can the unions battle?

Within hours of GoLocal breaking the news of the merger, the United Nurses and Allied Professionals (UNAP) President Linda McDonald, RN, released the following statement today:

"This proposed merger has the ability to impact thousands of jobs and the quality of care in Rhode Island and should be thoroughly scrutinized. Like most Rhode Islanders, we only recently learned of this proposal but expect Care New England and Partners HealthCare to be transparent in their process and begin a conversation with our union about the effect any deal would have on our members and our patients.  

Memorial Hospital provides critical care to scores of Blackstone Valley residents every year and preserving its status as a fully-functioning community hospital will be among our top priorities as this process continues to unfold. 
The onus is now on Care New England, Partners HealthCare and Prime Healthcare Services to make the details of this proposal public and to do it quickly so that workers, patients and state regulators may begin asking the appropriate questions."

The nurses represents nearly 1,400 registered nurses, CNAs, ER techs, surgical techs, orderlies, endo techs, environmental employees and ancillary staff at Kent and Memorial hospitals.  But, will they have any impact on the decisions?

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Speaking of Lifespan - will they be forced to merge with a Boston partner?

Lifespan is having its financial challenges too. While Care New England lost $53 million last year, Lifespan's losses were $40 million. The Lifespan losses were smaller proportionately to the healthcare group's overall budget and it does not have the cash crunch that Care New England was battling.

In February, Lifespan announced it had has entered into another Boston Hospital agreement. This agreement with Dana-Farber Cancer Institute is a long term agreement with the goal of advancing cancer treatment and research. Lifespan previously entered into an agreement with New England Medical Center and that deal led to years of protracted litigation to unwind. Lifespan also ran into a legal battle with Tufts Medical Center.

Will Partners' potential arrival in the market force Lifespan to affiliate?


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