Friday, July 11, 2014

Leading? Hardly.

Well, we could scarcely expect him to say something else, but the CEO of Partners Healthcare System really went out on a limb when he told the Boston Globe:

“The formation of Partners has been a great thing. Care has gotten so much better.”

Well, no, it has not.  Here's a more accurate description from Dr. Eugene Lindsey, the former head of the state's largest multi-specialty group, which has referred patients to Partners for two decades:

If the motivation of Partners over the last twenty years has been to use its market power to really integrate care and lower the cost of care, they have failed monumentally. The care within Partners is no more integrated, and certainly much more costly than in any other healthcare system in the state, the nation, on this planet, and therefore presumably anywhere in the universe. Partners offers spectacular care in specific areas at a high cost.

Partners’ performance on some of the metrics of care that is routine in the community arguably falls short from being unequivocally “the best,” although its price never reflects that reality. What it does succeed at is finance, marketing, government relations and intimidation of other members of the healthcare industry. There has never been a credible analysis that shows that Partners' care significantly exceeds in technical quality, access, patient satisfaction, patient-centeredness, or safety when compared with the other less generously paid academic medical centers in Massachusetts.

Referring to a New York Times editorial, he adds:

Given this reality and the reality that it is the most expensive provider of care in the Massachusetts healthcare market, the Times has made an egregious error to suggest that Partners has been a leader in collaborating to control costs and improve care.

1 comment:

Barry Carol said...

I wonder what percentage of PHS’ inpatient and outpatient caseload is being referred to their system by doctors not employed by or affiliated with PHS. If these doctors presumably know that PHS’ contract prices are significantly higher than competitors, then why are they referring patients there, especially for routine care that can be done perfectly well just about anywhere? Do patients prefer to go to PHS hospitals because the amenities are better and they’re insulated from the incremental cost? If so, a strong case can be made for insurers to make sure that patients share incremental cost through network tiering.

I also wonder about overall hospital capacity and occupancy rates in the Boston market. If some of the Steward hospitals start to close in the next 12-24 months, can those patients easily be absorbed by the remaining hospitals? In theory, it’s possible that there will be fewer inpatient bed days systemwide and fewer outpatient procedures performed so even if the majority of that business moves to PHS, total medical costs in the Boston region could still fall.

I don’t fully understand why employers and unions are so accepting of PHS’ market dominance. The only thing I can think of us that they only have so much political capital and can only fight so many battles at once and this battle doesn’t make the cut, at least for now.