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Medical Center to develop new state healthcare system

Published: Thursday, October 4, 2012

Updated: Thursday, October 4, 2012 08:10

 

Tufts Medical Center, the Boston teaching hospital affiliated with the Tufts School of Medicine, last month announced that it has entered into exclusive negotiations with Vanguard Health Systems to create a new system of healthcare for Massachusetts. 

Tufts Medical Center and Vanguard Health Systems are working together with Tufts’ physician’s group, New England Quality Care Alliance (NEQCA), to revise the way many hospitals in the state are managed. 

Tufts Medical Center Physician-in-Chief Deeb Salem explained that one of the goals of the collaboration is to create a high-quality healthcare system for Massachusetts patients that is also affordable. 

“That’s what not only the country needs, but particularly Massachusetts, where healthcare is so expensive and is driven by institutions that are large and that have very high rates that the insurance companies pay,” Salem said. “We’ve certainly worked hard to do so and continue to be one of the highest-quality centers in the county.”

Negotiations for the system will be completed sometime this fall, according to Senior Vice President of Strategic Services at Tufts Medical Center Deborah Joelson.

Joelson explained that integrated systems like this already exist in Massachusetts. 

“We know that with the world changing and how reimbursement is happening for healthcare, we want to be well-positioned to manage populations and participate in Medicare shared savings programs and global payment contracts
 to be able to develop the infrastructure to do that well,” Joelson said.

Tufts Medical Center, Vanguard Health Systems and NEQCA will also sponsor the Minuteman Health Initiative, a non-profit health plan that recently received an $88.5 million loan from the Centers for Medicare & Medicaid Services, according to the Tufts Medical Center website.

“[The loan] will be available as we are constructing the company,” Salem said. “You just can’t open up an insurance company without any funding. But it’s a loan that gets paid back as the insurance company succeeds.” 

Tufts Medical has a three-year relationship with Vanguard Health Systems through MetroWest Medical Center in Framingham and Natick, which Vanguard owns. 

“I think the success and trust that we’ve developed working together in those projects have led to this,” Salem said.

Joelson explained that each of the three groups will bring different strengths to the collaboration. 

“NEQCA ... has expertise in care management, contracting with insurance companies, data and analysis and a lot of the infrastructure that is needed to manage care in the future, and that’s the expertise that Vanguard was interested in supporting in the market,” she said.

Tufts Medical Center will help by providing high-end services in a cost-effective manner, according to Joelson.

“Vanguard really brings to the table a presence in Massachusetts through their ownership of MetroWest Medical Center and Saint Vincent’s Hospital, as well as the management expertise that they have in running hospitals nationally,” she said. “So we will look to them as we think about ways to be more efficient.” 

Joelson noted that there is an academic component of the collaboration through developing relationships with community hospitals and examining how future physicians will work in the community. 

“A lot of the academic medical centers are accused of sucking patients out of the community,” Salem said. “A lot of what we’re doing is helping the community build services that are equivalent to what you’d get in an academic medical center by having our own faculty actually work there.” 

Joelson said that Tufts Medical Center is excited about the collaboration.

“We like to say that you don’t have to build a system by owning everything, and so this is an attempt to be creative and keep Tufts as an independent hospital in certain ways,” she said. “We’re looking forward to it.” 

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