Wednesday, April 15, 2015

A market shift in Boston

It may or may not be a big deal, but these things don't happen too often.  It appears from a recent "Notice of Material Change" filing that Steward Health Care System is leaving Children's Hospital Boston behind to enter into a deal with Partners Healthcare System to provide pediatric and newborn services.

If you go to the current Steward maternity services website, you find:

Steward maintains a partnership with Children's Hospital Boston, which provides our pediatric patients with access to the most advanced treatment available. Patients have access to in-house Children's Hospital Boston pediatricians around the clock, seven days a week.

The Holy Family hospital site goes into further detail:

Holy Family's partnership with Children's Hospital Boston provides newborns with access to the most advanced treatment available. Children's Hospital neonatologists staff our Special Care Nursery, working closely with community obstetricians, maternal/fetal medicine specialists, community pediatricians and pediatric specialists to ensure optimal coordination of care.

In the event that neonatal patients require the most critical care, they have access to clinical services at the Level III Neonatal Intensive Care Unit at St. Elizabeth's Medical Center in Boston or at Children's Hospital Boston. 

St. Elizabeth's notes in turn:

We can also arrange excellence sub-specialty care for your child through our affiliation with Children's Hospital Boston.

But the NMC says this will change on July 1, as follows:

The NMC says that the new arrangement will, among other things:

Lower total medical spending for newborn medicine and pediatric services without compromising the quality of or access to such services.

There may be more, or less, here than meets the eye. Steward already has deep relationships with Partners for trauma care and adult tertiary and quaternary care.  Those arrangements were signed notwithstanding the higher cost of services provided through Partners compared to all other academic medical centers in Boston.

So, is this latest shift just part of a continuing, gradual absorption by Partners of Steward services?  Or, are we seeing real competition in action, i.e., that Partners has chosen to "lower total medical spending" by underpricing Children's Hospital?

1 comment:

Anonymous said...

Not sure what it means either.

But when the largest and second largest health networks appear to slowly forming a partnership with limited or no public comment that concerns me.

I have seen nothing in the Globe, Herald, Boston Business Journal and no comment by the Health Policy Commission or Attorney General

South Shore Hospital and Hallmark combined are less than half the size of Steward. Yet, the world is in an uproar over one and seemingly ignores the other.

Partners is now the referral site for new born and pediatric medicine. Paul has said they are already the referral sight for adult medicine. Dana Farber, Partners clinical affiliate has control of much of the hematology and oncology at Steward. How much control by Partners is too much?

If Partners has approximately 6000 or 6500 doctors and Steward has approximately 3000 doctors that is a combined total of over 9000 doctors concentrated in Eastern Massachusetts.

At what point does monopoly come into play?