The Boston hospital wars, and how the Partners HealthCare empire is growing

This is getting very ugly.

The Boston Globe writes another piece on Partners HealthCare, the conglomerate comprising of twin titans Massachusetts General and Brigham and Women’s Hospitals.

Previously, it was spotlighted that Partners’ facilities and doctors received payments in excess of the region’s competing medical institutions.

Today, the concern is how Partners is expanding to suburban areas, putting community hospitals at risk.

Partners appears unapologetic and shows no restraint in fighting back the claims. Most entertaining is Jack Connors, a longtime Partners chairman, who holds nothing back.

Commenting on the criticism of Partners’ clout, he defiantly says, “I frankly think that some of it is jealousy. Maybe that’s not fair, but that’s how I read it.”

He pulls no punches in calling out Paul Levy, CEO of competing BI-Deaconess Medical Center (who blogs at Running a hospital): “There are not enough crying towels to keep this guy in service. . . . He can’t get rolls of dimes fast enough to drop dimes to complain about Partners.”

Or Charlie Baker for that matter, CEO of Harvard Pilgrim Health Care (who also blogs at Let’s Talk Health Care): “Charlie once told me that he wakes up every morning wondering if this is the day Blue Cross is going to decide to put him out of business. So Charlie’s convinced himself he has to be nervous. . . . Charlie gets right over there on the Paul Levy side of the pew.”

Fightin’ words indeed.

Partners comes off as arrogant in the piece, and Connors would be better served by projecting a bit of humility. However, my overall take has not changed. They are practicing smart business in a ruthless competitive medical environment, and are leveraging patient demand for “brand-name” medicine brilliantly.

We are in an age where being placed on a US News top 10 list speaks more volumes than any advertising campaign from a community hospital, hit pieces from a newspaper, or anything coming out of the Dartmouth Atlas. Remember, a local insurer tried to play hardball with Partners by dropping coverage to their network of doctors. Patients revolted by threatening to change insurers, and retain their access to MGH and the Brigham. The insurer acquiesced.

Partners recognizes this fact. Thomas Lee, chief executive of the Partners physician network, assesses the situation perfectly: “No one can stop this. This is not something that Partners is doing to community hospitals. . . . This isn’t Partners. This is the natural changes occurring in the marketplace.”

What’s the answer? You have to remove the patient demand for the Massachusetts General or Brigham name, and brand-name medicine in general. Do this, and Partners’ clout will evaporate overnight. That’s a difficult task no doubt, but it’s clear that’s what Paul Levy and Charlie Baker, as well a cadre of health policy wonks, are trying to do both in blogs and various media interviews. A public re-education campaign delinking patient outcomes from brand seems to be the guerilla-style tactics Partners’ adversaries are taking.

Massachusetts is growing increasingly concerned at the impending monopoly in Boston’s health care market. Public health commissioner John Auerbach says that patient choice remains paramount, and that “the degree to which consolidation eliminates choice for patients, I don’t think that’s good. I think that patients should always have a choice.”

The problem is, patients have already made their choice. And so far, it’s resoundingly in favor of Partners HealthCare.

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