In a community-wide email sent yesterday, President Christina Paxson P’19 announced the University’s proposal to work with Prospect Medical Holdings — a California-based hospital chain — in merging with Care New England, the second largest health care system in Rhode Island. The University’s offer arrives amid efforts by Partners HealthCare, the largest health care system in Massachusetts, to acquire CNE.
CNE, which lost over $53 million in 2016, owns Women & Infants, Butler, Memorial and Kent Hospitals in Rhode Island. CNE and Partners announced in April 2017 that they were exploring merger options, as GoLocal Prov previously reported.
In a conference call with members of the press, Paxson said the University’s concern with Partners stems from the fact that it is not a local health care system, adding that “its center of gravity is in Massachusetts.”
CNE’s acquisition by Partners, which also operates Massachusetts General Hospital and Brigham and Women’s Hospital, would likely shift specialty health care to the neighboring state, limiting access to health care “for Rhode Islanders and especially for members of the state’s underserved communities,” according to Paxson’s email.
“My concern is that if specialty care moves north, then the doctors and researchers who supply that care will not want to be in Rhode Island,” Paxson told the press.
This shift could increase the costs of health care, wrote Cass Cliatt, vice president for communications, in an email to The Herald. Citing a 2015 cost of care study, Cliatt wrote that Rhode Island currently has “substantially lower professional costs than Massachusetts and the New England Region. … Shifting patients out of state would increase costs to consumers, payers (insurance companies, the state) and employers.”
This shift would also hinder “the full economic benefits of a strong local academic health system that brings in federal grants, generates spin-off companies and creates new jobs in Rhode Island,” according to Paxson’s email.
The Brown-Prospect plan includes provisions for the University, or another nonprofit subsidiary of Brown, to acquire the Women & Infants Hospital while allowing Prospect to acquire Kent and its “non-hospital assets such as The Providence Center community mental health organization,” Paxson wrote. If CNE allows discussions to move forward, the University and Prospect would determine the acquisition of Butler in the future.
Under its proposal, the University would also invite “the medical school faculty at Women & Infants, Butler and Kent … to join a Brown faculty practice plan or to become Brown employees,” according to Paxson’s email. Additionally, Brown would reinvest the majority of any operating margins it receives into clinical care, medical research and education.
The uncertainty surrounding the “status of the acquisition of Care of New England by Partners … (and) uncertainty among people in the state” delayed the University’s announcement of its proposal, Paxson told the press.
Last month, Partners and CNE announced that they would be extending merger talks through Jan. 31, according to the Boston Globe.
The University will submit its plan to CNE for consideration “if the Partners acquisition does not go forward, either because Partners withdraws, or its application to the state is denied,” according to Paxson’s email.
But the University’s proposal has received criticism from CNE and other stakeholders.
Jim Beardsworth, spokesman for CNE, said the Brown-Prospect plan “represents their intention to acquire and split up the Care New England Health System — a process undertaken of their own independent action and interests,” WPRI reported. Beardsworth added that CNE intends to continue its discussions with Partners.
Paxson told the press that CNE’s reaction to the deal was surprising, but that “we are outlining an alternative that seeks to assist Care of New England by offering … to join with them in keeping health care in Rhode Island.”
“We’re taking a position on an issue of vital public importance,” she said. Paxson added that she “thought it was just important to make it clear that there are other options that the people of Rhode Island can consider.”
The University has also been criticized for partnering with Prospect to develop an alternative deal. The United Nurses and Allied Professionals union raised questions about Prospect’s safety record, citing issues with “patient infection and injury,” the Providence Journal reported.
But Cliatt reiterated the University’s support for Prospect. “Prospect’s hospitals in Rhode Island have received national recognition for the quality of care they deliver,” Cliatt wrote. “Brown feels that the significant investments Prospect has made in its facilities, technology and people in Rhode Island reflect its strong, continued commitment to Rhode Island and its health care system.”
In the same conference call, Thomas Reardon, president of Prospect Medical Holdings East, said Prospect looked forward to working with “the University, physicians, elected officials and the community to … ensure all Rhode Islanders continue to have access to quality, locally-driven health care.”
Paxson said that despite being a California-based, for-profit company, Prospect does not intend to move research and specialty practice out of Rhode Island, the Journal reported.
If the merger between CNE and Partners is successful, the University is “committed to working with Partners to maintain the productive relationship that Brown has enjoyed with CNE,” according to Paxson’s email.
The Herald could not reach representatives from Partners and Care New England for comment by press time.
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