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The Massachusetts Policy Policy Commission said in its new report that the proposed merger could increase total health spending by $ 171 million a year. This could result from the significantly improved leverage of the new system with the payers.
In addition, the commission found that the new system, called Beth Israel Lahey Health, would feature a small number of Medicaid patients, low-income patients and minorities compared to other major systems in eastern Massachusetts. The parties to the merger have so far refused to commit to expanding access to Medicaid patients.
The findings were similar to the commission's previous report in July, which the merger partners rejected in a 64-page rebuttal.
"Although they are good institutions, they have put the merger in place to create more serious problems for low-income patients and community hospitals," said Stuart Altman, chair of the health policy commission. professor at Brandeis University. He called the commission's estimates of spending increases resulting from the "conservative" merger.
Dr. Kevin Tabb, CEO of Beth Israel, who has been appointed CEO of Beth Israel Lahey Health, said the merger partners will work with state officials to address the concerns raised by the commission. .
"We are confident that the creation of Beth Israel Lahey Health will strengthen patient care, reduce healthcare cost growth and expand access – and introduce significant competition in the Massachusetts health care market", was he said in a statement.
In their rebuttal in August, the merger partners argued that the commission's methodology was flawed and that the merger would yield estimated annual savings of $ 149 million to $ 270 million five years after the end. reconciliation.
The agreement signed last October involves Beth Israel in Boston and Lahey in Burlington, Massachusetts, as well as the New England Baptist Hospital in Boston, Mount Auburn Hospital in Cambridge and Anna Jaques Hospital in Newburyport. The new system would include 10 acute care hospitals, the largest in the state. There would also be three hospitals affiliated with the Cambridge Health Alliance, Lawrence General Hospital and Metrowest Medical Center and more than 4,000 physicians.
The new system would be the second largest in Massachusetts, behind Partners HealthCare. The fusion partners said the agreement would eventually reduce costs, partly by attracting patients from partners.
The commission's new report states that if merger partners' plans to focus on lower-cost metrics can result in savings, these savings will not offset increases in spending if the parties get the expected price increases. He noted that the parties have refused to make commitments to limit future price increases.
Altman said that he expects the merger partners to respond with proposals to address the concerns of the commission, contrary to their response to the preliminary report. "I am rather optimistic this time, they will take much more seriously," he said.
He expressed confidence that Massachusetts Attorney Maura Healey and the state's public health department, which has authority over hospital mergers, will have to make significant changes to the merger deal. .
The proposed merger can not be finalized until 30 days after the commission's report. The Attorney General and the Commissioner of the Department of Public Health may take additional measures regarding the 30-day period.
Altman urged other states to establish a similar model of fact finding and revision when hospital systems propose to merge. "It's a very useful process," he said. "We have allowed too many mergers to have negative implications, and we have done nothing to mitigate them."
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