Rhode Island’s two largest health care systems Lifespan and Care New England saw their Hospital Conversions Act application deemed complete and accepted for review by Rhode Island Attorney General Peter F. Neronha and Director of Rhode Island Department of Health Nicole Alexander-Scott, according to a press release from the Attorney General’s Office.
The review period under the HCA began Nov. 17 and will last 120 days. After the review period, the attorney general will decide whether to approve, approve with conditions or deny the merger.
According to the press release, “an HCA application is deemed complete when enough information has been provided by the transacting parties to begin the review” and is “a procedural milestone.” Still, completeness does not indicate that “regulators have resolved all of their questions or that new questions will not arise as the review moves forward.”
With the merger application completed, the Attorney General’s Office will “perform confidentiality determinations” by Dec. 30, Public Information Officer at the Attorney General’s Office Kristy dosReis wrote in an email to The Herald. The application will be made public once the process is finished, and public meetings will be scheduled within two months of the day that the application goes public.
Lifespan and Care New England had submitted a revised application to the Attorney General’s Office Oct. 1 in order to address questions of “charity care, quality, population health, health equities and diversity,” The Herald previously reported.
The University announced in April that it had signed agreements to form an integrated academic health system with Lifespan and Care New England, a partnership through which Brown will contribute research and medical education while the two health care systems provide clinical practice and resources from teaching hospitals. The ultimate goal of the system will be to provide Rhode Islanders with world-class physicians and “health care from birth to end of life,” President Christina Paxson P’19 previously wrote in an email to The Herald.
University Spokesperson Brian Clark wrote in an email to The Herald that “Brown is not a direct party to the merger under review.” He added that the application's acceptance does not affect the University’s plan to have an “affiliation agreement” with the “new merged entity” if the merger is approved.
According to a joint statement — which was reviewed by The Herald — by President and CEO of Lifespan Timothy Babineau, President and CEO of Care New England James Fanale and Paxson, Lifespan and Care New England had asked the Rhode Island Foundation to “lead an independent review and provide recommendations on how best to build an integrated academic health system in Rhode Island that is inclusive and beneficial to all.”
The RI Foundation has led an independent effort to “gather and share community input aimed at informing the proposed Lifespan/Care New England hospital merger and creation of an integrated academic health system through an affiliation with Brown University,” according to a Nov. 17 RI Foundation press release.
The RI Foundation assembled a committee of 25 members, aiming to “develop a set of clear recommendations for consideration by the Department of Health, office of the Attorney General, elected officials, Lifespan, Care New England, Brown University and the broader community.”
In a report published Nov. 17, the RI Foundation laid out eight “priority areas,” including “equity,” “access,” “workforce,” “community responsibility” and “governance.” The report also contains input from “multiple community outreach efforts.”
Babineau, Fanale and Paxson wrote that “equity, access and community responsibility to ensure affordable and quality healthcare” are “at the core of (their) efforts to develop an academic health system for the benefit of people of (their) state.”
They wrote that the report’s conclusions are “squarely aligned” with their belief that the merged entity and the University should form a system that “meets the needs of all in our community, across race, language and income.”
State Representative David Morales MPA’19 (D-Providence) urged “state regulators to carefully weigh the potential effects on patient care and employment when analyzing the proposed merger between the state’s two largest health systems.”
“We should be incredibly cautious of a proposal that seeks to create a gigantic conglomerate in an industry that, by its very nature, requires personal, individual care,” Morales said in a Nov. 16 press release.
Morales expressed concern about the “potential for higher healthcare costs, lower quality of care for patients and worker layoffs,” adding that strict regulations must be applied if such a merger is to move forward, such as “a cap on hospital revenue, metrics that demonstrate an improvement for the quality of care patients receive and stricter oversight on employment practices.”