PROVIDENCE – Providers, health care executives, union representatives and members of the public weighed in on the proposed merger between Lifespan Corp. and Care New England Health System at a highly attended meeting on Thursday evening.
Speakers expressed divided views on the merger’s impacts, with supporters arguing that it would expand access to patient care, integration of treatment and scientific innovation in the state. Opponents pointed to research finding that mergers in other states created monopolies and increased health care costs without benefits to patients and workers.
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The meeting was the first of two currently scheduled sessions for the public to provide feedback on the application for Lifespan and Care New England, the state’s two largest health care entities, to merge into an integrated academic health system with Brown University. The application marks the fourth time that Lifespan and Care New England have attempted to merge since 1998.
The meeting kicked off with various executives and providers from Lifespan, Care New England and Brown speaking in support of the merger.
Dr. Raymond Powrie, chief clinical officer at Care New England, said that the merger would improve continuity of care, particularly when patients may need to have providers in both systems depending on their specific health needs. For instance, patients commonly manage their reproductive health at Care New England, he said, and cardiac care at Lifespan.
“This creates a fragmentation in health care that women experience in this state,” Powrie said, which causes inconvenience at minimum and, at its worst, harm to patients.
“The good doctors and nurses on either side work hard to bridge these gaps, and I think most of the time we achieve it,” Powrie said. But, this integration “should be part of a structural system,” he said.
Dr. Frank Savoretti, an independent primary care physician based in Johnston, spoke against the merger, saying it would threaten smaller health care providers and decrease accountability in patient care.
If approved, the combined health care system would threaten “all the little guys like me, who represent only their patients and are not employed by a huge corporation like Lifespan or Care New England,” Savoretti said. “It would take very little for them to create a situation that would put me out of practice.”
The combined health care system would be the largest single employer in the state and comprise around 80% of the state’s hospital infrastructure.
Dr. Jody Underwood, chief of psychiatry at Lifespan, said that the merger would improve resources for behavioral health and bring experts together amid a sharp increase in need for mental health care.
“Currently, there are too many silos of care,” Underwood said, and not enough integration and resources to meet patients’ needs.
While some took a strong stance for or against the merger, others expressed that the integrated academic health system offers promising benefits, but would need to be passed with certain conditions in place to protect patients and workers.
“Any merged entity needs to ensure that at the end of it, there will be more union workers than there are now in health care,” said Dawn Williams, a nurse at Butler Hospital and one of several Service Employees International Union 1199 New England union members to speak at the meeting. “Otherwise, the system will simply be too big, with too much power and too little accountability.”
Other speakers expressed concerns over diversity among the health system’s leadership and called for greater equity efforts, while some questioned how the merger will affect consolidation of positions and job status of people who currently work for the separate systems.
Dr. Luis Daniel Muñoz, member of the State Equity Council, said that though Lifespan and Care New England executives have claimed the merger would improve equity for underserved populations, just integrating the systems will not fix long-standing inequalities.
“Starting with the obvious history of how marginalized communities have been treated, Black and brown communities … this merger should not be the start of equity,” Muñoz said.
The meeting reached a height of more than 250 attendees about an hour into the session, which ran for just over two hours.
The state will hold a second public comment meeting on Jan. 26 from 3 to 5 p.m., and may hold a third in February, according to the R.I. Office of the Attorney General. Members of the public may also submit written comment by Feb. 1.
The merger requires approval from the R.I. Department of Health, R.I. Office of the Attorney General and the Federal Trade Commission to move forward.
Jacquelyn Voghel is a PBN staff writer. Contact her at Voghel@PBN.com.
