No one would tell you Kevin Tabb set the town on fire when he touched down in Boston two years ago and, looking back, that may explain a lot of what’s happened since.
Tabb arrived as the new chief executive of Beth Israel Deaconess Medical Center, an outsider plunging into the insider’s world of big Boston medicine. He came from California — Israel before that — and spent part of his working life employed at big companies such as General Electric. He had zero experience as the chief executive of anything.
In person, Tabb is engaging but disarmingly low-key. Keep in mind, this is the guy who succeeded Paul Levy, a chief executive who wrote a widely read blog about running a hospital and gave as much as he got in a very public union battle. Think of it as a CEO personality transplant.
Some people, and I’m talking about me, had a hard time seeing how Tabb would get a lot done at Beth Israel as hospitals across Massachusetts launched themselves into a frenzy of mergers and affiliations.
But two years later, he has emerged as a clear winner. Now Tabb, 49, is negotiating his most ambitious deal of all, a three-way combination with Lahey hospital and Atrius Health that would truly transform Beth Israel — if he can pull it off.
Time is starting to run out on the wave of hospital consolidations, and Tabb knows it. “I believe this market will shake out in the next 24 months at most,” he says. “Pretty much, the lines will be drawn.”
Translation: At that point, most hospitals in Eastern Massachusetts will have been drawn into some kind of relationship with a few big players: Partners HealthCare, Steward Health Care System, and Beth Israel.
All three are trying to build health systems that cover a lot of ground and can do it all — primary care, lower-cost routine hospital care in the suburbs, and specialized treatment for the very sick in the city. The idea: more seamless care that doesn’t let patients slip through the cracks. It’s also supposed to cost less. Believe that when you see it.
This is by far the most important wave of local medical consolidation in 20 years. In the early 1990s, Beth Israel was the big Harvard teaching hospital on the outside looking in when Massachusetts General Hospital merged with Brigham and Women’s to create the Partners system.
Tabb isn’t easily drawn into conversations about the past, but he knows that history lesson well. (One of two books on his office coffee table is an academic volume analyzing three past hospital mergers, including the Mass. General/Brigham one.)
Here in the present, Beth Israel has managed a series of deals to expand its influence and strengthen its reach south of Boston. It first acquired Milton Hospital and then formed an alliance with Signature Healthcare Brockton Hospital.
Most recently, it signed off on a merger with Jordan Hospital in Plymouth.
In each case, Tabb and Beth Israel succeeded by winning a competition against other suitors.
How much did that matter to the others? Tufts Medical Center’s chief, Eric Byer, resigned shortly after his hospital, first passed over in Brockton, also lost out in Plymouth.
And how did Beth Israel keep winning? Certainly its board remained committed to expansion, and that means being prepared to spend money.
Beth Israel helped sell itself as a stable nonprofit option compared with other bidders. Its own finances were rock-solid and didn’t answer to any private equity investors.
And Tabb himself, a practitioner of low-key persuasion, has something about him that got one hospital executive after the next to say yes.
Now Beth Israel is in three-way talks with Lahey Health in Burlington and Atrius Health, a giant physician organization that includes Harvard Vanguard Medical Associates.
“It’s very compelling to have us all together,” Tabb says. “But not everything that makes sense ends up happening.”
The catch: Getting the groups to agree is much harder than any other negotiation Beth Israel has attempted.
It got even tougher when Atrius chief
Gene Lindsey stepped down two months ago, leaving that organization with an acting chief executive.
But a combination with those Atrius doctors and an important suburban hospital to the north would change Beth Israel. It would have all the pieces of the health system Tabb talks about.
And that would be a very big deal, indeed.