Winners and losers from the Partners deal fallout

01.27.2015

Originally ran in the Boston Globe

By Shirley Leung, Globe Columnist

No judge or jury delivered a verdict on the Partners HealthCare settlement Monday, but we didn’t need either after Attorney General Maura Healey’s three-page court filing.

She thinks the deal stinks, and if given the chance, she would bring an antitrust suit to block Partners’ efforts to expand. And just like that, the 43-year-old rising political star dared to rock the biggest boat in Massachusetts health care. In the wake of her threat, Healey left a list of winners and losers.

WINNERS

Maura Healey. On the campaign trail, this political neophyte expressed skepticism about the proposed deal brokered by then-attorney general Martha Coakley to allow Partners to acquire three hospitals in exchange for capping prices and agreeing to other limits. But I don’t think anyone expected Healey to drop a bomb. As one of Coakley’s deputies, she oversaw units working on the settlement but left to run for AG before an agreement was struck. It took moxie not only to go against her old boss but also her colleagues. By weighing in on Partners clearly and swiftly, Healey showed she wants to be a player, even if it means ripping off the Band-Aid and starting a new course of treatment to contain health care costs.

Superior Court Judge Janet Sanders. If you want advice on how to deftly get

out of making a tough decision, talk to Judge Sanders. She was faced with whether to approve a controversial pact that nobody except Coakley and Partners seemed to favor. The judge had concerns but didn’t seem comfortable rejecting it outright in the middle of Coakley’s run for governor. So Sanders dragged out the process past the November election. When Coakley lost, Sanders mused out loud in court that she would like to hear from AG-elect Healey on the matter. Talk about passing the buck! The judge still has to issue a ruling, but it seems unlikely she would approve it over Healey’s objections.

Howard Grant, Mike Wagner, and coalition forces. Nothing brings together competitors like a sworn enemy, and the prospect of an even mightier Partners created a coalition of hospitals to loudly oppose the deal. A group of hospital executives submitted a scathing filing to the AG warning that the tentative pact could have “profound and negative effects on the cost of health care.” Front and center were Grant, the chief executive of Lahey Health, and Wagner, the Tufts Medical chief executive, voices that can be tough to hear in a medical landscape dominated by Harvard teaching hospitals. Not anymore.

Beth Israel Deaconess Medical Center. It is the “other Harvard teaching hospital” — the one left at the altar when Brigham and Women’s and Massachusetts General hospitals merged in 1994 to form Partners HealthCare. A weakened Partners is good for Beth Israel and chief executive Kevin Tabb.

Health Policy Commission. It’s the state watchdog agency with no real power — other than the power of persuasion. The commission looked like it was going to roll over and let Partners get its way when chairman Stuart Altman initially said he was “very pleased” with the settlement. But as opposition grew, so did the commission’s concern that a bigger Partners would be a bad outcome. One key finding: The mergers could raise costs by nearly $50 million a year for the three largest health insurers.

LOSERS

Martha Coakley. It’s not fun kicking someone while they are down, but here I go. Coakley lost the election to Charlie Baker and now this. Faced with filing a lawsuit to stop Partners or striking a difficult deal, the ever-cautious Coakley chose the more politically palatable path. She, along with Partners, misread the temperature on how people felt about Goliath getting bigger — and now they are both paying the price.

Gary Gottlieb. The settlement perhaps exemplified how tone deaf the outgoing chief executive had become. After a Globe Spotlight series and amid US Department of Justice and state AG investigations about market clout, Gottlieb, with the blessing of the Partners board, boldly pursued an acquisition strategy to bring higher quality care to more communities. Perhaps Gottlieb’s miscalculations hastened his impending departure. Expect Partners to put the brakes on its buying spree until the new poohbah arrives. Good luck finding a chief executive to clean up the mess.

Blue Cross Blue Shield. Boo-hoo for Blue Cross, the state’s biggest health insurer, for staying on the sidelines of this dogfight. Meanwhile, the Massachusetts Association of Health Plans went to the mat and let it be known that the settlement could drive up medical costs and premiums. Their message was so effective that Healey cited the insurers’ concern in her Monday filing as a reason why the deal needed to be stopped.

South Shore Hospital & Hallmark Health. Three hospitals desperately wanted to be part of the Partners network. Now what? I’m less worried about South Shore in Weymouth — which is still affiliated with the Brigham and is a formidable medical center on its own. But Hallmark’s two community hospitals in Medford and Melrose are smaller, and while there will be other suitors, it will be hard to find an owner as powerful as Partners.

Shirley Leung is a Globe columnist. She can be reached at shirley.leung@globe.com. Follow her on Twitter @leung.


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