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Tufts, Vanguard Eyeing Possible Partnership

BOSTON — In the medical Mecca that is Boston, it’s pretty hard these days to keep track of which hospital or doctor belongs to which network. And that landscape is shifting again.

Tufts Medical Center is teaming up with national for-profit health care provider Vanguard Health Systems to form what may be the next big hospital network in Massachusetts.

So what does this mean for you? Well, maybe a lot. WBUR’s Martha Bebinger joins All Things Considered host Deborah Becker to explain.

Deborah Becker: Let’s back up. Why are we seeing, first off, so much change in ownership among hospitals?

Martha Bebinger: So we’ve talked a little bit about changing the way we pay doctors and hospitals — putting them more on a budget, asking them to manage the care for patients with diabetes and asthma. To do that, they have to have a big electronic medical records systems, crunch data, keep track of who’s doing what all the time and that’s really hard for small hospitals and small physician groups. So many people think that over the next three to five years, we’re going to shrink all of the 60 or so acute care hospitals we have in Massachusetts into about five — maybe even less — big health care systems.

Because this will help control costs?

It will help control costs because they will be providing all that you need under one umbrella, managing it, making sure you’re not getting extra tests when you don’t need them, making sure you’re getting the best deal for those tests, and tracking what happens to you after that test.

So, Tufts and Vanguard are forming a partnership, or a joint venture, is what they’re saying. Where is this headed?

Well they are hoping to become one of these big health care systems. Right now, we have Partners HealthCare, we have Steward — that’s the former Caritas system, they’re still growing of course — and we’re seeing many other systems that want to compete, too. So this is Tufts and Vanguard coming together to figure out what they can do to build a bigger hospital network.

So here’s what Tufts CEO Eric Beyer said this new partnership is about – really an extension or an expansion of what they’ve been doing already:

That’s something we’re bringing to the market, an infrastructure that’s built, a relationship with community hospitals and physicians that exists, and a proven track record in keeping care that can and should stay in the community there and actually enhancing the capabilities of care in those communities that we work with.

You mentioned that some folks want to compete so they’re affiliating to be larger, to be competitive. But is that the best always for care? And what happens then if a patient wants to go somewhere else to get care?

That’s the balancing act. In many ways for you and I, as patients, it’s better to have our care under one of these big umbrella groups. The doctors, in theory, are talking to each other more often, they’re sharing information and records, they’re coordinating our care.

The downside is that if you decide the best doctor for you, the best treatment for you is outside that network and you want to go there, you’re probably going to get a fight. We’re starting to see some of that already. If a doctor says to you, “No, you can’t go somewhere else,” what they’re probably saying is we don’t want you to go there and you need to have a conversations with them about why.

In the case of Tufts, this is a nonprofit teaming up with a for-profit — and a national one — that’s pretty unusual, isn’t it?

It’s very unusual in Massachusetts, not quite so unusual in the rest of the country. But as Erik Wexler, the CEO of Saint Vincent Hospital in Worcester, one of the Vanguard hospitals, said, he doesn’t really think it makes that much of a difference in Massachusetts:

I actually find the differences between not-for-profit and for-profit really narrowing. That our goal is to provide top quality care and to do it in an efficient way. And in the Vanguard system we have demonstrated our ability to do that. In fact, compared to other hospitals in the region that Vanguard New England owns, our cost structure is much less.

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