PBN Summit: CNE, Lifespan move toward definitive agreement, merger filing

PANELISTS DISCUSS telemedicine during Providence Business News' Health Care Summit on Thurday. From left is PBN Editor Michael Mello; Marie Ganim, R.I. health insurance commissioner; Dr. Alan Kurose, Coastal Medical CEO; Dr. Kenneth Wood, Lifespan Corp. executive vice president and chief clinical officer; and Dr. James Fanale, CEO and president of Care New England Health System.
PANELISTS DISCUSS telemedicine during Providence Business News' Health Care Summit on Thurday. From left is PBN Editor Michael Mello; Marie Ganim, R.I. health insurance commissioner; Dr. Alan Kurose, Coastal Medical CEO; Dr. Kenneth Wood, Lifespan Corp. executive vice president and chief clinical officer; and Dr. James Fanale, CEO and president of Care New England Health System.

PROVIDENCE – Dr. James E. Fanale, CEO and president of Care New England Health System, said Thursday that the merger between CNE and Lifespan Corp. is still on track, but a merger application likely will not be submitted to the state by the end of the year.

During PBN’s virtual Health Care Summit on Thursday morning, Fanale made it clear that there’s still a lot of work that needs to be done, but Rhode Island’s largest hospital groups are determined to work toward signing a “definitive agreement” soon, which will help the organizations move forward in filing an application that will be submitted to the R.I. Department of Health and the Office of the Attorney General.

View PBN’s virtual Health Care Summit here.

“By the end of the year, we’d like to have the definitive agreement signed,” said Fanale. “But I’m not sure if it’s going to get done by the end of the year. We’re still incredibly optimistic. There’s no obstacles. But we still have a lot of work to do even once we get the definitive agreement signed.”

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Lifespan and CNE say this is the fourth attempt at a merger for the two systems since the 1990s, but have said since their announcement in September that this effort was different.

In the beginning days of the coronavirus pandemic in Rhode Island, Fanale said both systems had to stop their educational programs and send those in clinical rotations home because of the lack of personal protective equipment. Fanale said the two systems were already working together, such as exchanging medical supplies.

“The pandemic has kind of pushed us together,” Fanale said at the Health Care Summit.

Thursday’s summit offered two panel discussions:

Joining Fanale in the first discussion was Marie Ganim, R.I. health insurance commissioner; Dr. Alan Kurose, Coastal Medical CEO; and Dr. Kenneth Wood, Lifespan Corp. executive vice president and chief clinical officer.

The other panel featured Dr. Claire Levesque, Tufts Health Plan chief medical officer; Peter Marino, Neighborhood Health Plan of Rhode Island CEO and president, Siobhain Sullivan, chief operating officer of clinical operations; and Dr. Matt Collins, Blue Cross & Blue Shield of Rhode Island executive vice president and chief medical officer.

While health systems across the state are taking the lessons they had learned during March and April when it was still unclear on how to treat patients with COVID-19, those on the first panel said it was important to stick to the same procedures, such as the coverage of telehealth, as Rhode Island and the rest of the country see another surge in new cases.

“Telehealth is virtually a lifesaver,” said Ganim, who noted that in the beginning months of the pandemic, many Rhode Islanders were told to contact their primary care doctors. However, she said patients were skeptical of going into a doctor’s office, and providers didn’t exactly want a room full of patients who could spread the virus.

Kurose said that telehealth continues to be critical for patients as winter approaches, and he cited the high prevalence of the coronavirus in Rhode Island as cases continue to climb. He said that last week, 54% of encounters with patients were done by telehealth while 46% were done face to face.

“We can’t go much [more] above that,” said Kurose.

Wood, Lifespan’s newly hired executive vice president and chief clinical officer, has a background of using telehealth in other systems, and before the pandemic encouraged more providers to use it. He said that as elective surgeries and cancer diagnostic procedures have been delayed, telehealth could help health providers meet with patients safely during any additional surges of COVID-19, as long as it is covered by health insurance.

“This is going to be an incredibly pertinent issue in terms of reimbursement,” said Wood. “The demonstrated value is substantial.”

But Ganim, who has supported telehealth during the pandemic so far, said it’s not just as simple as Rhode Island mandating it on the state level, but it will also need federal dollars.

Ganim said it’s not as easy as saying that every state, and the federal government, are all going to say that every telephonic visit and every audio-visual visit will be reimbursed thee same way as an in-person visit.

“It’s probably not going to happen,” she said.

In the summit’s second panel, participants warned that the recent surge in COVID-19 cases meant companies need to stay vigilant. A return to normal, whatever that may mean, is still a ways away.

“A lot of businesses are going to have to reassess their timelines in terms of bringing people back in to the office,” said Marino.

He compared the early response to the pandemic to flipping a light switch – it was either on or off.  In the future, he said, companies will need to use the equivalent of a dimmer switch to gradually respond to changing conditions.

In response to a question the future of the Affordable Care Act, better known as Obamacare, panelists said they are deeply concerned, particularly in light of an upcoming Supreme Court case. In November, the high court is expected to hear oral arguments in a case seeking to overturn the health care law.

Millions of Americans could lose their health insurance if the law is struck down.

“I remember treating patients before the Affordable Care Act; there was a huge change that came about as a result of the act,” said Collins.  “We created access to health insurance.  It would be unconscionable to say, ‘Let’s just get rid of Obamacare.’ ”

Alexa Gagosz is a PBN staff writer. Contact her at Gagosz@PBN.com. You may also follow her on Twitter at @AlexaGagosz. Writer Andy Smith contributed to the story.

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