Waterbury Hospital on Robbins Street in Waterbury, CT, one of three Connecticut hospitals owned by Prospect Medical Holdings. Credit: Viktoria Sundqvist / CTNewsJunkie
HARTFORD, CT — It’s been a busy time for healthcare in Connecticut, with the potential sale of three hospitals and the formation of a new healthcare system announced last week. However, lawmakers and experts are expressing caution about the potential drawbacks of further hospital consolidation.
Last week, UConn Health announced its plan to submit a bid for Waterbury Hospital. Purchasing the hospital would be a cornerstone of Uconn Health’s plan to establish a new healthcare system in the state, alongside Hartford Healthcare and Yale-New Haven Health.
On Friday, news also broke that Hartford Healthcare is submitting an $86 million bid to purchase the other two hospitals held by Prospect in Connecticut.
State legislative leaders from both sides of the aisle said they were encouraged by the steps being taken by UConn Health to address the “serious challenges” which resulted from the Prospect bankruptcy. However, in a letter sent to UConn Health and signed by the leadership of both House and Senate Democrats and Republicans, the lawmakers expressed concern about the need for the state to take on associated debt service obligations.
Chair of the General Assembly’s public health committee state Sen. Saud Anwar, D-South Windsor, was similarly optimistic about the bid by Hartford Healthcare, especially its potential to reduce private equity’s presence in Connecticut healthcare.
“This is incredibly welcome news for health care in the state of Connecticut. I fully endorse and encourage Hartford HealthCare’s bid to purchase these hospitals, which would preserve local community care in Manchester, Vernon and their surrounding towns and cities,” he said in a statement.
However, there are potential pitfalls to the continued consolidation of Connecticut’s hospitals. Professor Reena Kelly, who specializes in the study of healthcare systems at the University of New Haven, said in a phone interview that while larger systems offer greater economies of scale for sharing resources and exercising more bargaining power with insurers and vendors, that size can also become a drawback when it comes to patient care.
“One of the downsides is that system level care takes away the ability, to some extent, for hospitals to have that personal touch with their patients,” she said. “If there was a community hospital, it would be located in the county somewhere. Most of the people that would work there would be local. Your providers likely live somewhere close by, so there’s a lot more integration in the community.”
At a system level, some of that gets taken away due to “the sort of metaphorical distance between people at the front who are providing care and the system head, which is where a lot of the decisions are made,” she said.
Kelly said in theory, those economies of scale should lead to savings for consumers, but the reality is not always so cut and dry. She said consolidation can limit patient choice, as multiple hospitals in a given area may belong to the same system.
“The other thing outside of choice, is the system has a lot more power in being able to set prices,” she said. “And so those prices could be higher than what an independent community hospital sets, because the reality is larger system hospitals or health systems have overhead type expenses that they have to cover. They have multiple business units within the larger system, and the reality is that they all have to generate some sort of profit at some point.”
Whichever way the various bids go, Kelly said she hoped the situation was resolved for the sake of both patients and employees at the affected hospitals. She said worries about job security could lead to chronic stress for employees, which could have downstream impacts on the quality of care that patients are receiving.
“The clinical providers, non-clinical providers, billers, coders, anybody who’s working there, dealing with the constant back and forth that comes with wondering, ‘Are we going to be taken over? Are we not? Are we going to have a job? Are we not? Do I have enough money to, you know, make rent or pay the mortgage next month?’” she said. “Those are real questions, and these are people who have sort of been in this turmoil state for a few years now, and it’s a very hard place to be.”