SET TO ACQUIRE two hospitals owned by bankrupt Steward Health Care, Lawrence General Hospital’s president, Abha Agrawal, has a vision for a large, regional health care system in the Merrimack Valley.
The purchase of the two Holy Family hospitals in Methuen and Haverhill by Lawrence General – a safety net hospital – is slated to take place by Tuesday. Lawrence General will pay $28 million to buy the properties and the state will contribute money to support the hospitals’ operations. The state is expected to provide more than $489 million over three years to help all of the new owners of Steward’s hospitals.
“Most people wanted to believe in the vision – that if we can create the system of scale and stability, and hopefully not just more of the same thing,” Agrawal said on a Health or Consequences episode of The Codcast with Paul Hattis of the Lown Institute and John McDonough of Harvard’s Chan School of Public Health. “Now we have this community-based system that we can scale.”
The vision includes culturally competent care to a diverse, multi-ethnic community that Agrawal hopes to serve effectively for many years to come. Supported by innovations in payment approaches that are not strictly volume-related, Agrawal also hopes to be able to transform regional health care delivery through use of AI and other technologies. She did not go into detail on the changes.
Most importantly, she wants the hospital system to prioritize patient safety. Under Steward, there have been reports of patients not receiving appropriate care due to a lack of equipment or staffing.
“Our team has very clear guiding principles [and] our first [one] is: protect the patient,” said Agrawal. “The second is: protect the team [and] give them what they need in order to execute on the first principle, to protect the patient.”
Agrawal said that she felt strongly about acquiring the two hospitals even though it seemed like an “audacious and impossible” idea. Agrawal said the close proximity of both hospitals to Lawrence General and the impact that the closure of either facility would have on her hospital factored into the decision to buy the Holy Family hospital campuses.
“It’s happening so much in our backyard and it is going to impact us,” said Agrawal. “So just watching it and say, ‘well, it’s not my problem, it’s Steward’s problem,’ was absolutely not an option from every perspective. If there was an abrupt reduction or discontinuation of services, there [would] be tremendous challenges in access to care and…we [would] have significant overcrowding and adverse impact to us as well.”
However, there are challenges ahead for Lawrence General if the transfer goes through. The hospital has faced its own financial issues over the last few years and Agrawal said that there was some concern that a struggling Lawrence General would have a hard time taking on two more hospitals that are in dire financial circumstances.
“Everyone from my own team to our board to state officials wanted to know: if you can’t make – not me personally – one hospital work, how would you make more than one hospital work?” said Agrawal. “And are we multiplying the problem or are we creating a new vision and a new solution.”
But Agrawal said Lawrence General is beginning to turn around under her leadership. The hospital has in the past needed money from the state to balance its books – two years ago the state provided $35 million and last year it was $30 million. This year, however, Agrawal expects the hospital won’t need any supplemental payments from the state.
Agrawal is optimistic Lawrence General will be able to turn the Steward hospitals into functional community-focused hospitals. She said there is a lot of work to be done to make up for the severe underinvestment the hospitals experienced under Steward. She said resources will be needed to fix issues with the facilities and equip them properly. She also expressed concern that there would have to be a lot of work to repair the breach of trust between the Steward hospitals and their stakeholders, including patients, physicians, the community, and even local hospital vendors, some of whom have not been paid over the last few years.
“The breach is palpable,” said Agrawal. “So what I would like to do…is start to repair the breach between a health care delivery institution and the patients and the communities and families. So we can create the system that we really set out to create.”
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