The University signed agreements to form an integrated academic health system for Rhode Island in conjunction with Lifespan and Care New England, the state’s largest health care systems, according to a Feb. 23 community-wide email from President Christina Paxson P ’19.
This merger will bring together resources and clinical practice from teaching hospitals in the Lifespan and Care New England groups with research and medical education from the University and its Alpert Medical School, Paxson wrote.
The University has committed to invest at least $125 million over the next five years into the development of the new system. The distribution of these funds will be developed in a joint strategic planning process between the University and the merged health systems, Paxson said in an interview with The Herald.
The new medical system will be shaped with the intention of providing Rhode Island with “health care from birth to end of life,” personalized medical services and world-class physicians, Paxson wrote. The system will also merge Lifespan and Care New England’s health management, clinical care, biomedical research, medical education and health care research under one health system that is affiliated with the University, Paxson wrote.
“The significance should be felt by people who live in Rhode Island,” Paxson said. “The important question is what will it do to improve the quality of care while keeping costs down and also jumpstarting more research that leads to economic development.”
Currently, Lifespan and Care New England maintain different medical focuses and specialties. For instance, neonatology is housed at Care New England’s Women and Infants Hospital, but women who suffer birth complications must be transferred to Lifespan’s Rhode Island Hospital through a tunnel that connects the two institutions.
“You're treating patients who are going to both systems, but they don't act as one system,” Paxson said. “That increases cost, that reduces quality.” It also introduces complications in maintaining medical records, Paxson added.
The University will have voting membership on the Board of Directors of the new health system created as a result of the merger. Additionally, the chair of the health system or their designee will have voting membership in the Corporation, the University’s highest governing body. Lifespan and Care New England will have other representatives join the Corporation’s Med School subcommittee, Paxson said.
The University is not legally involved with the health system merger between Lifespan and Care New England. “But the way we really create the partnership is through some shared governance,” Paxson said. “That's how you start to break down barriers and create collaboration, goodwill and a shared commitment to each other.”
Lifespan and Care New England announced in September their intention to merge into one health care system. Rhode Island is currently one of the only states in the country that does not yet have an integrated academic health system, said Lifespan President and CEO Timothy Babineau in a video discussion between the leadership overseeing the new partnership.
The merger will become official pending state and federal approval, which the University, Lifespan and Care New England predict will take several months.
“Health care in Rhode Island has been fragmented for decades, completely fragmented,” Babineau said in the leadership discussion. “When patients need to bounce in between systems … quality goes down.” After the partnership is implemented, the care patients receive “will be even better than it is today, and it’s pretty darn good today,” he added.
Integrated academic health systems have both economic and health care benefits, Paxson explained in her email.
An integrated academic health care model has had great economic success in cities such as Pittsburgh and Chicago, Paxson wrote. She hopes that this merger will “bring together the expertise and capacity needed to create exactly the kind of integrated academic health system that has provided such dramatic success in other places,” she wrote.
The partnership aims to promote a “bio-innovation ecosystem” in which researchers work with clinicians to generate intellectual property that attracts funding and industry partnerships, Paxson wrote.
The integration of health systems and the development of new intellectual property will lead to the creation of new biotech companies and more jobs in Rhode Island, Paxson told The Herald. The merger will also bring economic growth in the form of ancillary businesses needed to support the influx of people and businesses in the state, she added.
“A lot of that (growth) initially should take place in the Jewelry District, which is an area that Brown has been investing a lot and is being thought of as the medical hub, biotech hub of Providence,” Paxson said.
An integrated academic health system will also attract more “superstar physicians” to the state, who will in turn be able to provide care to Rhode Island residents and train the next generation of doctors, Paxson said.
“We attract amazing students,” Paxson said. “Giving them even better experiences will be a big plus to this merger.”
The University’s biomedical research will inform clinical care in areas such as cancer, Alzheimer’s disease and ALS, Paxson wrote. While many physicians working at both Lifespan and Care New England are also University faculty members, conducting joint research is as logistically difficult as if “they were doing research with someone in San Francisco,” Paxson said. The merger will allow for more integrated research opportunities between the health system and the University.
“We've been working with these complementary but different health care systems, and it's made it very difficult to coordinate research that's integrated in with medical care,” Paxson said.
The partnership will position the health system to receive a designation from the National Cancer Institute, which is the “highest classification for cancer care across the country,” Paxson wrote. This could give Rhode Island residents with cancer the opportunity to stay and be treated in the state instead of seeking care out of state in Boston or New York, Paxson said in the leadership discussion.
The merger will also address disparities in health care and improve population health based on strategies developed at the Med School and School of Public Health.
“Health care should improve for everybody, but we need to reduce the gaps between wealthier and less wealthy people and also across different races and ethnicities where there are glaring, glaring disparities in health, as we've seen during the pandemic,” Paxson said.
Other goals for the merger include decreasing the costs of health care and working with health insurance companies and the state government to reduce behaviors such as smoking and exposure to environmental toxins that can result in disease.
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