Gov. Dannel Malloy last week approved an affiliation between the Yale-New Haven Health system and the New London, Connecticut-based Lawrence+Memorial Health care system. As a result, the Yale-New Haven Health system will see the addition of two new hospitals: Westerly Hospital in Rhode Island and L+M.
L+M health care will join the Yale-New Haven Health system as a full corporate member. The hospitals are the first to do so since Greenwich Hospital in 1998. Unlike the affiliation that would follow a merger, YNHH and L+M will each retain their own board of directors with fiduciary responsibility, as well as maintain separate licenses and medical staff. The arrangement will allow the New London area hospitals access to the resources and physicians of the Yale-New Haven health system, which includes Yale-New Haven Hospital, Greenwich Hospital and Bridgeport Hospital.
“Essentially what this does is it allows [Lawrence+Memorial hospital] and Westerly to continue to provide care to the region as we both have been for 104 years and 90 years by aligning ourselves with Yale-New Haven Health system and being able to tap into resources to bring providers here,” said Michael O’Farrell, director of communications and marketing at Lawrence+Memorial hospital. “This is not a situation where we’re looking to send more people to New Haven. We are looking to bring more doctors into our communities.”
O’Farrell added that the affiliation will allow patients in New London to receive care from Yale-New Haven Health system physicians, who would not otherwise have cause to provide clinical services in that community. Dean of the Yale School of Medicine Robert Alpern said the affiliation will also benefit the clinical practice of the Yale School of Medicine.
Alpern also said the affiliation would prevent L+M from losing money, as it had done in the past. Because patients requiring tertiary care have often been sent from L+M to YNHH, strengthening the relationship between the hospitals facilitates more effective care, Alpern said.
The recent approval comes in the wake of an executive order Malloy signed last February which blocked the affiliation due to concerns about health care costs and access within the state. The order instructed the Connecticut Office of Health Care Access to deny affiliation applications from hospital systems whose combined operating revenue would exceed 20 percent of all operating health care revenue within the state. The order was designed to prevent a small number of hospital systems from controlling the state’s health care market.
The executive order was amended last Wednesday so that it no longer specifies that affiliation applications from health care systems of this size be automatically denied. Instead, the order now only requires that OCHA take into account the size of the health care system during their deliberation. As a result, OCHA successfully approved the affiliation on Thursday.
Malloy spokesman Chris McClure added that Yale has demonstrated to the governor’s office that its proposed affiliation with L+M will not restrict access to health care across the state.
“Yale, shortly after the first order was issued, very cordially and voluntarily came to our office,” McClure said. “They came to us as the office of the governor to discuss the executive order and how that by virtue of merging they wouldn’t become the thing we were afraid of — too big, during negotiations with insurance companies and Medicaid be able to dominate, or else close down L+M and lay off staff. Yale was able to assuage all those concerns. That’s why the governor felt comfortable amending the order.”
Alpern said the governor’s concerns regarding access to affordable health care are justified, noting that because Yale-New Haven Hospital is an academic medical center, its cost of care is higher than that of many community hospitals in the state.
O’Farrell said the affiliation was approved in Rhode Island on Sept. 1, following extensive review by the three state bodies responsible for evaluating hospital affiliation applications — the Department of Health, the Health Services Council and the Office of the Attorney General.
Ronald Vender, the chief medical officer for Yale Medicine, said he was supportive of the affiliation between the two systems.
“I think it’s a fabulous development for southeastern Connecticut,” Vender said. “I have family in New London area and they are absolutely delighted that L+M is affiliated with a system of the caliber of Yale-New Haven Health. They look at this as a great facility for their community and to continue to access outstanding medical care in their community and I believe it’s good for Yale-New Haven Health system as well.”
However, a community coalition that includes the National Physicians Alliance and the Universal Health Care Foundation of Connecticut has voiced concern regarding the affiliation.
In a statement released last Friday, Stephen Smith, a professor emeritus at the Brown University Warren Alpert Medical School and member of the coalition, expressed doubts about the swift approval of the affiliation.
“Of immediate concern is the process that led to last night’s decision,” Smith said. “Specifically, state regulators released the document as a Final Order, without the opportunity for the community to digest it and offer comment.”
Smith added that the coalition will continue to consider its next steps in moving forward with the affiliation to ensure the health of the community and that it remains committed to affordability, workforce continuity and stability within the health care sector.
Marna Borgstrom SPH ’79 has been president and CEO of both Yale-New Haven Hospital and Yale-New Haven Health system since 2005.