Ambulatory care expansion was high on the list of priorities that leaders at Care New England Health System brought to Partners HealthCare this past spring, when the two systems seemed poised for a merger.
A building currently housing a medical practice on the Butler Hospital campus in Providence was the most promising spot to begin, Care New England CEO and President Dr. James E. Fanale suggested in April.
See related story: CNE plots solo course (for now)
But the deal between CNE and Partners fell apart a few months later when Partners pulled its application after Gov. Gina M. Raimondo intervened, calling on CNE, Lifespan Corp. and Brown University to work on a unified, in-state health care system.
The three-way talks ended last month without a deal, leaving CNE to move on, at least for now, without a partner. Expanding ambulatory care services, however, is still under consideration, Fanale says.
The system continues to eye the outpatient building at Butler Hospital in Providence, and is considering possibilities in Warwick.
“The question is, what else could we use that property for,” Fanale said of the Butler location. “We own it, it’s in a beautiful place, it’s got great parking, so we’ll figure out what to do.”
While different organizations offer varying definitions of ambulatory care, the state’s largest health care networks generally offer versions that extend beyond primary care but do not require a hospital check-in. Minor surgeries, dialysis and some cancer treatments fall under the umbrella.
‘The whole trend of health care has been to reduce time spent in the hospital.’
DR. STEVEN LAMPERT, Lifespan Physician Group president
The Rhode Island Hospital Association, citing a policy against speaking publicly on clinical issues, declined to comment on whether there is a current need for additional ambulatory care statewide. Lifespan, though, says there is.
“We are trying to improve our access out in the community with various medical disciplines or specialties,” said Dr. Steven Lampert, president of Lifespan Physician Group. The network already has placed neurosurgeons offering specialized ambulatory care in Newport and East Greenwich. Infusion centers offering treatment for cancer and other conditions are in East Greenwich and East Providence, and a third is planned for Smithfield. Cardiologists are even more widespread. Recently, Lampert said, a heart patient needed an outpatient test and she was offered four different times at four different locations.
Lifespan also has plans to expand pediatric offices and create other clinics in Lincoln that will provide cardiology, endocrinology, pulmonary and nephrology services.
“We’re developing this kind of hub-and-spoke approach to some of our specialty services,” Lampert added. “The whole trend of health care has been to reduce time spent in the hospital.”
So far, CNE has not offered specifics on its ambulatory expansion.
“We have important plans to grow our system, explore new clinical opportunities and improve facilities,” said CNE spokesman Jim Beardsworth. He declined to provide details as to what, if any, more ambulatory care services the network plans to offer either on the Butler campus or elsewhere.
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OPTIONS: Care New England CEO and President Dr. James E. Fanale says the company is considering what to do with an outpatient building containing a medical practice with some empty space that it owns on the Butler Hospital campus in Providence. One option is to use it for expanded ambulatory care services. / PBN PHOTO/TRACY JENKINS[/caption]
Currently, buildings on the former Memorial Hospital campus in Pawtucket house outpatient offerings, including primary care, specialty services and a walk-in clinic, that are “busy and growing,” Fanale said.
Jane Hayward, CEO of the Rhode Island Health Center Association, which oversees eight federally qualified primary care centers, says it’s difficult to gauge whether the state has a need for more outpatient services.
“It’s more complicated than a yes or no. I think that what we know is we need to have people seen in more ambulatory care settings, as opposed to settings that have a higher acuity,” she said, referring to emergency room visits for minor ailments. “To the extent that people are having difficulty getting into practices to see a primary care physician then yes, there should be more.”
An increasingly competitive market is leading to concentration in available care, Hayward added.
“You have seen health systems buy up primary care centers in an attempt to control the cost continuity,” she said.
Elizabeth Graham is a PBN staff writer. Contact her at Graham@PBN.com.