The growth of for-profit health care
The hallmarks of any good organization are quality and efficiency.
Any business offering a similar at a lower price will almost always succeed in the marketplace. Sure, mitigating factors like taxes, regulation and global competition can throw a company off-track; but for services inherently local – like health care – quality and efficiency are central to a winning formula.
For-profit healthcare providers have been around Central Massachusetts since the first doctor decided to charge fees for services, but our region did not have a major player until 2005 when Tennessee for-profit Vanguard Health System purchased the 124-year-old Saint Vincent Hospital in Worcester. In 2013 Vanguard was purchased by Tenet Healthcare, and Tenet's regional system includes The Metro West Medical Center in Framingham, Leonard Morse Hospital in Natick, the Worcester Surgical Center and three MedPost Urgent Care Centers in Franklin, Northboro and Wayland. The for-profit wave has escalated in the region in the last six months: In November, Steward Health Care System of Boston partnered with the Central Massachusetts Independent Physician Association; and in January, Louisiana for-profit Amedisys Inc. bought out the home care division of Worcester nonprofit Fallon and VNA Home Care.
This increased number of healthcare providers who have shareholders to be accountable to, as well as running a healthy organization, has brought the role of for-profit health care further into the spotlight. UMass Memorial President & CEO Eric Dickson told Emily Micucci in her cover story this issue on for-profit health he is wary for-profit providers will focus more on the services with the biggest margins than the services the community needs. While those fears may be well founded, a 2014 study from Harvard University and Boston's Brigham and Women's Hospital shows that the record of hospitals switching from a nonprofit to a for-profit status resulted in greater financial stability while the quality of care was maintained.
Given government emphasis over the last 10 years for healthcare providers – both for-profit and nonprofit – to rein in the increasing costs of care, having more large, well-capitalized for-profit businesses move into the region may end up helping with these goals. Private enterprises have a long history of driving efficiencies while offering quality products. UMass Memorial and other nonprofit providers have the same challenges – running an efficient organization while increasing the quality of care to successfully competing in the market.
All providers must be held accountable for not only their quality of service, but that they also cover their fair share of the uncovered care burdens our communities face. Those burdens simply can't be left for one sector of the healthcare system to absorb. Agencies like the Massachusetts Health Policy Commission maintain responsibility to keep a watchful eye on the marketplace, and regularly review proposed acquisitions and mergers to ensure healthy competition remains. As long as they are vigilant, a competitive system should assure we get the best care at competitive prices.
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