tag:blogger.com,1999:blog-32053362.post8962066767970997465..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Dominance visualizedPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-32053362.post-51389551858780385562013-05-21T10:27:52.049-04:002013-05-21T10:27:52.049-04:00Paul - Let's not forget the other monopoly whi...Paul - Let's not forget the other monopoly which is Children's Hospital. Not only have they drawn in many community PCPs with their higher fee schedules but they also draw in many of the Pedicatric patients from other networks. Steward has something like 30% of all of their covered commercial lives with PCPs who are Pediatricians. Steward has little to no Pediatric services so all of that care ends up largely at Children's. They may not have the number of directly affiliated PCPs as Partners but they probably have close to that number feeding into their specialists and hospital (even though technically these Pediatricians are listed with Steward or Atrius or another network). Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-80293676922871570822013-05-20T11:01:57.413-04:002013-05-20T11:01:57.413-04:00Anonymous makes good points including the role of ...Anonymous makes good points including the role of Dana-Farber.<br /><br />Also omitted from the BCBSMAF report are the considerable other services and facilities with which Partners has substantial-to-dominant market share: McLean Hospital (behavioral health), Spaulding Rehab (a total of 6 inpatient facilities plus multiple outpatient units; the flagship campus is being replaced by a brand-new facility on the waterfront), and Partners Homecare which began acquiring a number of community home care agencies back in the 90s and is now quite large.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-18014483360299414902013-05-19T13:25:43.066-04:002013-05-19T13:25:43.066-04:00The numbers above understate Partners market domin...<br />The numbers above understate Partners market dominance for the following reasons:<br /><br />1) They are state wide numbers, when the market in Eastern Massachusetts has different dynamics from Central and Western Mass. <br /><br />2) Partners Mkt share doesn't include groups with which it has close alliances. For instance, Dana Farber has a close "CLINICAL" alignment with Partners and specifically Brigham and Womens. <br /><br />3) Partners community has concentrations of doctors at certain hospitals which it thereby dominates. Hallmark, Emerson, and Milford are all examples of this. <br /><br />4) Partners has requested that it be allowed to include in its network: South Shore, Hallmark and Cooley Dickson (which is outside the Eastern Mass market and not included in the figures below)<br /><br />5)Cape Code Healthcare announced last fall a strengthening of its relationship with Brigham and Womens and Cape Cod Healthcare doctors group is controlled by Steward, which we will see below, matters. <br /><br />6) Paul has said many times that Steward's tertiary care network is now Parters. So Steward now functions as another portion of the Partners community network. <br /><br />If you look at Net Patient Service Revenue (for 2011) for Eastern Mass, which is defined as those hospitals East of Worcester, not in the UMass system and leave out Childrens which is a specialty hospital, Partners dominance is much greater. <br /><br />It is approximately 43% in Eastern Mass for Partners hospitals plus Dana Farber, Mass Eye, South Shore, Milford, Emerson and Hallmark<br /><br />If Steward and Cape Cod healthcare are included it is approximately 55%. <br /><br />This is truly monopoly level power. <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-34476286457094470212013-05-19T08:45:10.349-04:002013-05-19T08:45:10.349-04:00I am starting to believe in the idea of consumer h...I am starting to believe in the idea of consumer health plans if they function like co-ops or are designed around PCMH and effective primary care financed by direct pts...Dino William Ramzihttps://www.blogger.com/profile/07237186267904028944noreply@blogger.com