Thursday, January 29, 2015

The judge saw through the lie

In a Boston Globe story, here's how Priyanka Dayal McCluskey reports on how the outgoing CEO of Partners Healthcare System described the deal that was turned down today by Suffolk Superior Court Judge Janet L. Sanders:

“The judge has said ‘no’ to an agreement that we believe would have paved a pathway to delivering high-quality care closer to home for patients and their families in a lower cost community-based setting."

Well, no.  First of all, there was no need for PHS to acquire these hospitals to achieve proper care management for patients.  All it takes is an agreement to coordinate care and share access to medical records.

Second, hospitals that would be incorporated into the PHS system would gradually assume the pricing advantages of this near-monopoly supplier and would not be lower cost community hospitals (compared to other community hospitals.)

Third, the agreement would have permitted PHS to recruit doctors in the vicinity of these hospitals, moving them from lower cost systems to the higher physician rates of pay enjoyed by the PHS doctors.

Attorney General Healey had it just right when she said that the proposed agreement was a case of the cart leading the horse. As many of us had noted, the commitments to lower costs contained therein were unsupportable and unenforceable. Instead, implicitly building on the findings of the state Health Policy Commission, she suggested:

“One of the greatest challenges our state faces is rising health care costs,” Healey said. “I’d like to see how [Partners’] work in the market is helping to contain costs.”

(By the way, should this case ever reopen, it would be good to see how an unfettered US Department of Justice would behave. Their position in this case was strange, compared to their other activities in the country.  One must assume that it was based on the Administration's desire to help a fellow Democrat in her gubernatorial campaign.)

In case you are interested, here's the full ruling by the judge. It is worth reading, at a minimum, the first few pages.


nonlocal MD said...

Partners may already be in violation of anti-trust laws, depending on how the feds define domination of a given market. Remember the federal investigation started before the latest deal did. Your AG should definitely invite them back into the case. Helpfully, Ms. Coakley has amassed a mountain of evidence against Partners, making it all the more suspicious that she ignored it all to their advantage. In sum, justice has been done for once - both that Ms. Coakley lost the election and Partners lost its sweetheart deal.

Gary M. Levin said...

This is what happens when health care is politicized.....

Anonymous said...

The PHS guys are not used to losing.
Not sure they have the DNA to regroup.

Hope their competitors have aligned themselves to take a real whack at them....would be good for all of us.

Anonymous said...

It takes a village, Paul. Thank you for your willingness to share honest and often unpopular perspectives on the powerful players that have controlled so much of what ails the health system in Massachusetts. The hijacking of the narrative has been difficult to unravel and expose. Much more work to do to keep the discussion fact-based and focused on all of the issues that need to be addressed.