Talking Politics: It’s clear changes are coming for R.I.’s hospital landscape

By Ian Donnis
Posted 3/11/22

STORY OF THE WEEK: The biggest certainty about Rhode Island’s hospital landscape is that more changes are ahead. After state and federal regulators recently rejected the Lifespan-Care New …

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Talking Politics: It’s clear changes are coming for R.I.’s hospital landscape

Posted

STORY OF THE WEEK: The biggest certainty about Rhode Island’s hospital landscape is that more changes are ahead. After state and federal regulators recently rejected the Lifespan-Care New England merger, CNE President/CEO Dr. James Fanale told me this week, “We are doing our due diligence on all options and keeping all options open.”

CNE includes Kent Hospital in Warwick and Butler and Women & Infants hospitals in Providence. Fanale said CNE’s financial challenges stem from how it lost more than $100 million on the now-shuttered Memorial Hospital in Pawtucket. “If we didn’t have that now and had that cash in the bank, we would have a liquid balance sheet. We wouldn’t be in the shape we’re in,” he said. “But you can’t go back.”

On the rejection of the merger, Fanale didn’t dispute the combined market share it would represent – panned by regulators as anti-competitive – although he maintained that healthcare quality would not suffer through a merger, and that fears about higher costs “would be drastically mitigated by some of the intervening powers of the state.”

For now, it remains unclear which entities beyond StoneBridge Healthcare will make overtures for CNE. (Also uncertain is the future ownership of Roger Williams Medical Center in Providence and Our Lady of Fatima Hospital in North Providence, now that CharterCare owner Prospect Medical Holdings is exploring a potential sale.) Any proposed transactions will be viewed through the prism of whether the buyer is from Rhode Island or out of state and whether it is a for-profit or not-for-profit organization. Asked about these differences, Fanale said they’re largely about the culture of different entities. CNE’s status as a not-for-profit is “in the nature of our DNA,” he added. “We would prefer to stay not-for-profit, but that doesn’t preclude looking at other options.”

 

LOCAL CONTROL: Chris Koller, formerly Rhode Island’s health insurance commissioner, and former state Health Department Director Dr. Michael Fine, sing from the same hymnal in expressing hope that Care New England can remain controlled by Rhode Islanders.

“From my standpoint, locally-based, locally-governed institutions stand the best chance of being good servants to the community and helping to improve the population's health,” Koller said on Political Roundtable. Fine points to how roughly 60 percent of hospital funding comes from publicly funded Medicaid and Medicare. He said a Lifespan-CNE merger could function in the public interest, but only if it operates under the aegis of a hospital regulatory commission “or something like that.”

Fine and Koller laid out their case in a recent Boston Globe op-ed for greater oversight and transparency on hospital finances. Is it realistic to think state government will offer that considering how, for example, the advisory Health Services Council last year recommended approving an ownership change for Prospect Medical despite concerns about the company’s finances?

“You know, what we really called for was leadership,” Fine responded, “and I think what we’ve been lacking is leadership in the healthcare sector and have been lacking it for many years … We need a clear set of goals and a clear commitment to building a healthcare system that takes care of all Rhode Islanders and that does so in a way that costs way less than it does now, that has good health outcomes and focuses on those good health outcomes, not on what providers of one sort or another need today.”

  

THE REGULATOR: Holly Vedova, director of the Federal Trade Commission’s Bureau of Competition, did not mince words in praising Lifespan and Care New England’s decision to terminate their merger proposal: “I am pleased that Lifespan and Care New England have abandoned their efforts to consummate an anticompetitive merger that should never have been attempted in the first place. Had the FTC and the Rhode Island Attorney General not challenged the proposed transaction, it would have combined the two largest healthcare providers in Rhode Island and created a dominant entity that would have led to higher prices and lower quality care for Rhode Islanders. I am proud to say that this is the third time in less than three weeks that merging parties have abandoned an anticompetitive transaction following an FTC challenge.”

 

ONE YEAR LATER – McKee Edition: Gov. Dan McKee marked his first year as governor this week, with a campaign video offering some highlights. Timing is one of the most valuable elements of politics, so the waning of the pandemic couldn’t be coming at a better interval for McKee’s political prospects.

The race for governor remains at a relatively low ebb for now, with no declared GOP candidate, Secretary of State Nellie Gorbea talking up her challenge to McKee, Helena Foulkes yet to introduce herself to voters through TV ads, and Matt Brown and Luis Daniel Munoz running from the left side of the spectrum.

 

ONE YEAR – Raimondo Edition: Former Gov. Gina Raimondo, now U.S. Commerce secretary, will be back in Providence for a March 15 speech at Brown University. Raimondo remains front and center in the news, serving as a messenger for the Biden administration on the economy and Ukraine, talking at MIT about getting the U.S. back in the microchip game, and even serving as the designated survivor during POTUS’ State of the Union address.

Raimondo’s political future remains a parlor game. Conservative broadcaster Hugh Hewitt is a steadfast fan. Last year, he called Raimondo the top rival to Kamala Harris in 2024. This week, he tweeted, “In four years she could be on the podium. The D bench is not deep and she’s terrific.”

  

SOTU: Via NPR’s Domenico Montanaro – Five takeaways from President Biden’s State of the Union address. Excerpt: “Biden tried to say he understands that inflation is pinching lots of Americans. ‘I grew up in a family where if the price of food went up, you felt it,’ the president said, before pointing out that that's why he pushed to pass the COVID-19 relief bill. It was almost as if the White House had read the NPR/PBS NewsHour/Marist poll, which asked Americans what they thought should be Biden's top priority. Far and away, the top answer was inflation. ‘I get it,’ he said. ‘That's why my top priority is getting prices under control.’

“Biden laid out a kitchen-sink approach. He said he authorized releasing oil from the Strategic Petroleum Reserve; he spoke out against price gouging; and he called for the confirmation of his Federal Reserve Board nominees. He also took a nationalistic turn, promoting making products in America.”

  

MARIJUANA: If it wasn’t already clear, 2022 is the year when Rhode Island will almost certainly legalize recreational marijuana, joining most of the other New England states that have done so. Sen. Josh Miller (D-Cranston) and Rep. Scott Slater (D-Providence) outlined the legislative proposal last week: legalization would take place in October, with a new process for taxing and overseeing up to 33 retail licenses in six zones around the state.

The sponsors talked up the measure and how it would address issues of equity and expungement. At the same time, critics said the Smith Hill plan doesn’t go far enough. The BLM RI PAC called for the automatic expungement of marijuana-related convictions. “Additionally,” the group said in a statement, “we encourage changes to increase the percentage of licensed applications from 25% to 50% to Black and Brown applicants. Many Black and Brown applicants do not currently have the network or financial capital it takes to be granted a license. Consequently, BLM RI PAC additionally recommends that the licensing fee be heavily reduced, ensuring that the application process is more equitable for all residents regardless of their socioeconomic background. Under this proposed legislation only the well-funded, connected applicants will stand a fighting chance. Thus, Rhode Island must secure that no unfair advantages are granted in the process of accepting licensing applicants.”

  

TREASURER: With Commerce Secretary Stefan Pryor expected to announce his run for treasurer by April 1, and R.I, Democratic Party Treasurer Liz Perik deciding against a statewide run this year, the only current treasurer candidate, former Central Falls Mayor James Diossa, is trying to build momentum, and announcing support from the following state lawmakers: Reps. Karen Alzate, Jean Philippe Barros, and Leonela Felix of Pawtucket; Jose Batista and Grace Diaz from Providence; Robert Craven Sr. from North Kingstown; Joshua Giraldo from Central Falls; and Evan Shanley from Warwick.

 

PROVIDENCE PENSION: Voters in Providence are set to take part in a June 7 vote on whether to borrow $515 million to shore up the city’s under-funded pension system. Although the vote is non-binding, it will serve as a gauge of where Providence residents stand on the issue. The latest proposed pension fix from Mayor Jorge Eloza is smaller than one last year that relied on a risky approach and an adviser linked with 38 Studios.

 

KICKER: Honorary Rhode Islander Mark Arsenault, an alum of the second-best Catholic college in greater Worcester and now an investigative reporter at The Boston Globe, will be at Books on the Square on April 5 to discuss his first nonfiction book, “The Imposter’s War,” with a fellow former ProJo colleague, Mike Stanton. Stay tuned for an upcoming interview with Mark on The Public’s Radio.

  

Ian Donnis can be reached at idonnis@ripr.org. You can follow him on Twitter @IanDon. For a longer version of this column or to sign up for email delivery, visit thepublicsradio.org

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