The tectonic plates undergirding the infrastructure of Rhode Island’s health care delivery system shifted significantly in 2011, and many of the aftershocks are still reverberating.
Landmark Medical Center, Woonsocket’s nonprofit, community, acute-care hospital, was sold to a for-profit hospital system owned by a private equity group.
A new online platform for buying health insurance, the R.I. Health Benefits Exchange, was created by Gov. Lincoln D. Chafee’s executive order then challenged in court.
And a new generation of leadership took the helm at many of the Ocean State’s most venerable health care institutions:
• Peter Andruszkiewicz replaced seven-year veteran James E. Purcell as president and CEO of Blue Cross & Blue Shield of Rhode Island, the state’s largest health insurer with more than 600,000 members and $1.6 billion in annual revenue.
• Dennis D. Keefe replaced John J. Hynes as president and CEO of Care New England, Rhode Island’s second-largest hospital system. Hynes had led Care New England since its formation in 1996.
• Martin E. Tursky was selected as the new president and CEO at Memorial Hospital of Rhode Island in Pawtucket, replacing Francis R. Dietz, who had served in that position since 1966.
• George Vecchione announced that he would be leaving as president and CEO of Lifespan, Rhode Island’s largest hospital system and the largest private employer, after 13 years.
Despite the changes, the health care delivery system remained, in the words of Dr. Michael Fine, director of the R.I. Department of Health, more of “a health care market” focused on wealth extraction. With health care costs growing about 18 percent a year, the current system is “unsustainable,” according to R.I. Health Insurance Commissioner Christopher F. Koller.
The biggest change is the pending $71.6 million sale of Landmark Medical Center in Woonsocket and the Rehabilitation Hospital of Rhode Island to the Boston-based Steward Health Care, a for-profit hospital system owned by Cerberus Capital Management.
If the R.I. attorney general’s office and the R.I. Department of Health OK the sale, it will be the first time a for-profit hospital system has purchased a community nonprofit hospital in Rhode Island.
Landmark’s sale is symptomatic of the financial weakness of acute-care community hospitals throughout the state. The result has been a game of financial musical chairs: merge, or affiliate, or be left without a partner.
• In July, Memorial Hospital celebrated a new clinical partnership with Brigham and Women’s Hospital in Boston for cardiovascular care.
• In September, Westerly Hospital announced plans to align itself with Lawrence & Memorial Hospital in New London, Conn., saying it was unable to go it alone financially.
Implementation of the Affordable Care Act, enacted in 2010, began in earnest, irrespective of legal challenges in the U.S. Supreme Court.
The new state insurance benefits exchange was established by executive order by Chafee in September and is expected to be paid for by more than $132 million in federal funds.
It is envisioned to serve as an online clearinghouse for health-insurance plans for 850,000 Rhode Islanders – everyone younger than 65. However, according to consultant Deborah Faulkner, out of an estimated 140,000 Rhode Islanders who are now uninsured, as many as 50,000 to 70,000 will remain uninsured, despite the exchange. •
