By JOHN HOWELL They come with different experiences and perspectives but a common goal to improve state health care services. Therefore, it wasn't surprising that two former presidents of Kent Hospital, John Hynes and Dr. Robert Baute, should question
They come with different experiences and perspectives but a common goal to improve state health care services.
Therefore, it wasn’t surprising that two former presidents of Kent Hospital, John Hynes and Dr. Robert Baute, should question Dr. James Fanale’s assessment that the Federal Trade Commission could pose the major hurdle to merging the state’s two largest health care systems, Lifespan and Care New England.
Fanale, president and CEO of CNE, spoke at the inaugural meeting of the President’s Advisory Board held online June 17. He focused much of the meeting on developments since the outbreak of the COVID-19 pandemic, including the financial impact on the institution, increased cooperation between the two health care systems and the renewal of merger discussions.
Baute, one of 74 members of the advisory board, thought that state regulators – not the FTC, which would be concerned with anti-trust regulations – would be the most difficult of regulatory bridges to cross. Baute speaks from experience. He led the 15-year crusade to give the hospital a cardiac catheterization lab capable of performing lifesaving emergency coronary angioplasties, which the lab started performing five years ago.
Hynes cautioned Fanale not to dismiss the role of the Rhode Island attorney general in a merger of the two systems, suggesting that could be the stumbling block.
In a telephone interview after the meeting, Fanale pointed out that times have changed – as have members of the regulatory boards at the state and FTC that would be reviewing a merger. He sees the local process as being “much smoother.”
He said that talks between CNE and Lifespan continue. He described it as a “process” but offered no projection on when a proposal might be ready.
During the meeting, Fanale gave an overview of CNE’s finances and how after closing Memorial in Pawtucket it managed to eke out a few million dollars.
“I guess if you look back on it, it was it was pretty good given the losses we had sustained in prior years, but clearly not a sustainable plan going forward,” he said. “That’s why we’ve always discussed about we need to be part of a bigger system.”
Fanale touched briefly on the plan to merge with Partners Health Care [now called Mass General Brigham], which he described as a deal that didn’t happen without going into the campaign Lifespan launched to nix the agreement that would have meant a substantial investment in Rhode Island. When that came apart, at the urging of Gov. Gina Raimondo CNE sat at the table with Lifespan, but that broke off after 30 days.
In an interview after the meeting, Baute felt the Partners deal offered the best outcome for CNE and the state.
He called these “tough times for hospitals” and questioned whether there ever be the capital to make the changes needed at Kent. He said the hospital needs private rooms for it to manage COVID and other improvements and he reasons “there would be some savings in the back room” if CNE and Lifespan were to merge. Nonetheless he questions if there are the resources to make improvements, adding: “I don’t think that money is going to be available to anyone very soon.”
While he commends Raimondo on the handling of the pandemic, he called her action to “torch Partners a huge mistake.”
“What she did is detrimental to health care in Rhode Island. Now we’ve got to pick up what we’ve got. This COVID thing is far from over. We’ve got another year of this in my mind,” he said.
Fanale told the advisory board that CNE and Lifespan worked closely on the COVID pandemic.
“Dr. [Timothy] Babineau [president and CEO of Lifespan] and I got together and we’ve been sharing practices together, we’ve been figuring out how to help each other. We’ve been setting up these alternate care sites. And quite frankly out of this plague, we call it common understanding of how well we can work together to take care of our patients better. So after a few weeks ago, we sat down together and said, do we think we should sit down and talk about the future?” Fanale said.
“We know we have to partner with somebody.”
In his discussions with Babineau, Fanale said the Mass General Brigham deal would not come back for at least a while. He said they also talked about what the state wants and what they believed the state would approve and he personally assessed other options in the region coming to the conclusion a CNE/Lifespan merger deserved exploration. The boards of both health care organizations were apprised of developments prior to a public announcement that discussions were being held.
Fanale is encouraged by the responses he’s received to the creation of the advisory board and the first meeting. He said it is important to connect with community leaders and to get their feedback.
Baute favors the creation of the advisory board adding, “whenever you try to communicate it’s good.”
Given the issues faced by the health care community, he thinks, however, that the three meetings a year being suggested by Fanale might not be enough.