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Sunday, October 30, 2016

Caution, oversight urged for corporate takeover deal that includes Westerly Hospital

Coalition seeks public role to protect patients
Matt O’Connor, AFT Connecticut

Image result for hospital mergerCommunity leaders, advocates, caregivers and area residents are urging the state's top health official to select a truly independent monitor to oversee the sale of Lawrence + Memorial (L+M) Health.

The coalition in a letter to the Department of Public Health (DPH) commissioner praises price caps in the agency's agreement green-lighting the purchase by Yale-New Haven Health Systems (YNHHS). They also at the same time question the settlement's requirements to retain vital services as "too narrow and vague" to protect the public.

"Yale-New Haven has essentially taken over Southern Connecticut's healthcare system," said Connecticut Citizen Action Group (CCAG) Executive Director Tom Swan. NOTE: this deal also swallows up Westerly Hospital and all its affiliated medical practices.

"This kind of change requires vigorous, transparent oversight — not a rubber stamp. The only way that patients and families will benefit from this deal is with a monitor and a consultant who are truly independent," added Swan, who in July provided testimony in the Certificate of Need (CON) hearings on the proposed acquisition conducted by the DPH's Office of Health Care Access (OHCA).

Swan's comments refer to the coalition's call for DPH to ensure a genuinely independent monitor to oversee consumer protections in the settlement approving the take-over by allowing  public input. Provisions in the agreement set annual caps on the growth of prices and some restrictions on YNHHS' ability to cut certain essential services currently provided by L+M.

"I have concerns that vital clinical services may not be retained at L+M," said Dr. Stephen R. Smith, MPH, a New London-based physician and professor emeritus of family medicine at Brown University's Warren Alpert Medical School. "The language of the agreed settlement is ambiguous and omits specific key services, such as pediatrics, surgery, laboratory and a sleep lab. What we need is a clear understanding of exactly which core services our patients can count on, and in the long-term," added Smith, who was granted intervenor status in the CON hearings.

Smith's comments refer to coalition members' concerns over narrow and vague language in the settlement regarding current L+M-provided services that YNHHS is required to preserve for the region. Many important conditions are additionally set to lapse after just three years, leaving the current geographic service area of 12 communities vulnerable to future loss of access to vital care.

"The settlement's pricing caps go a long way to address the core concern that brought our coalition together in the first place," said Universal Health Care Foundation of Connecticut Communications Coordinator Stephanye Clarke. "They point the way forward for future patient-centered health policy — but without an effective and independent consultant, they'll be worth little more than the paper they're printed on," added Clarke, a long-time healthcare advocate who also testified during the CON hearings in New London.

Clarke's comments refer to the coalition's December, 2015 release of data revealing that expansion of YNHHS threatened to bring large price spikes to healthcare consumers in the New London region. The settlement's provisions establishing price caps per unit of service contain vague language, leading to potential inaccuracies, inappropriate benchmarks and possible spikes in cost for certain payers and patients.

"To be clear, the settlement contains significant consumer and patient protections," said Stephanie Johnson, RPSGT, a sleep lab tech and president of AFT Local 5051, which represents medical technologists at L+M Hospital. "But it allows for Yale's executives to select an outside 'independent' monitor to serve as a watchdog for both the community and the health department. That's like letting the fox choose who ought to guard the henhouse," added Johnson, who was also granted intervenor status for OHCA's CON hearings.

Johnson's comments refer to shared concerns over settlement language regarding oversight provisions that come up short on both transparency and autonomy — essential for public trust in the process going forward. Coalition leaders in their letter urge community input into the selection of the independent monitor through either a Request for Proposals (RFP) process or public hearings prior to final approval.

A coalition of healthcare, consumer, civil rights and labor advocates came together in late 2015 to secure the high quality, affordable, community centered healthcare the people of Eastern Connecticut deserve. Participating groups represent community and faith leaders, patient advocates, physicians, caregivers and a diverse cross-section of area residents.