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Hospital finances
By adamg on Sun, 12/14/2014 - 9:50am
Paul Levy, who knows something about failing hospitals, having become CEO of Beth Israel just as the state wanted to shut it down, takes a look at the proposed merger of Boston Medical Center and Tufts Medical Center - and how to keep the merger from simply becoming " a case of strapping two leaky lifeboats together, leading to a faster demise than if they remained apart."
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Comments
I think this coupling should
I think this coupling should include the Quincy City Hospital as well . Maybe the new Governor can help , he has medical experience.
The next governor has
The next governor has experience kicking people off coverage, which is illegal now, and outsourcing jobs, which his fellow Harvard MBA buddy Romney also had but that doesn't tend to work out well for anyone but the men at the top.
Your lack of business knowledge is astounding
I don't even know where to begin about how Charlie Baker dropping people from coverage saved a company. (Side note: it's not like they couldn't get coverage somewhere else.)
It's 2014, almost 2015. It would be great if you could be gender neutral about people at the top. One of the most ruthless outsourcers is Fidelity (allegedly) which is run by -- guess what? -- a woman. Guess who decided to move hundreds of jobs out of Massachusetts as soon as Gov. Patrick left the country on a trade mission? Abby.
Now if you'll excuse me, I have a conference call with some developers in Krakow.
uh oh
I've had great experiences at Tufts over the past 10 years, and bad to horrible at Boston Medical since BU took over City Hospital (before that, despite being insanely overburdened, City Hospital provided me amazingly good surgical care). If the merger occurs, I hope the institutions themselves are allowed to maintain some separate governance.
I worked at BMC in the 2000s
I worked at BMC in the 2000s and it was probably less to do with the BU merger and more to do with how the place was being run. VP of nursing was a tyrannical idiot.
I am torn up about Tufts Medical Center being in trouble
First things first, I see a specialist there without whom I don't know what I'd do. He is better than any doctor at a Harvard/Partners hospital. He's also a teacher and a researcher. He loves students and I don't know what he'd do if Tufts Medical Center weren't around.
Secondly, Tufts Medical Center and BMC are important medical facilities to the City of Boston. They serve communities that are under-served and need their care.
Lastly, both hospitals are teaching hospitals. What would happen to Tufts and BU Medical Schools?
All good points. I thought
All good points. I thought BMC was guaranteed support to continue serving as the primary ER for Boston EMS by either the state or the city.
The medical schools were
The medical schools were intentionally not considered part of any merger talks, and would continue to be independent.
How they maintain their long standing clinical affiliations with their partner institutions after a merger is a good question though.
I thought Boston Medical Center was profitable?
This was a while ago, but a friend of mine who was a med student a few years ago told me that BMC was the only profitable hospital in the area. I guess that ain't the case anymore. Or he was wrong to begin with.
Your friend wasn't completely
Your friend wasn't completely off base, I hear of BMC being in the black from time to time: http://www.bostonglobe.com/business/2013/01/23/boston-medical-center-pos...
They were known for outcompeting other hospitals that saw a lot of Safety Net patients (uninsured care, somewhat compensated for the state, at a loss) by typically seeing the healthiest in this patient pool, therefore keeping this money losing care cost at a minimum. How they managed to attract the healthiest of the uninsured, I don't know or understand.
But he is off about BMC being one of the few profitable hospitals around: http://www.beckershospitalreview.com/finance/which-massachusetts-hospita...
I think your friend is wrong
Seeing as BMC treats a much higher proportion of Medicaid/underinsured/uninsured patients than say, MGH, their reimbursements for procedures are by definition going to be less, which means less money coming in.
A friend that had a rotation at BMC once told me that it was impressive BMC was still in business, so I guess that's saying something?
A few years ago getting those
A few years ago getting those kind of patients was still profitable, it is less so now. Reimbursement rates for Medicare are lower now.