LYNN — Partners HealthCare’s efforts to grow by acquiring more hospitals have come under fire from competitors, politicians, and policy experts, worried about medical costs, market power, and the goals of health care reform.
But here, the concerns are more personal. If Partners wins approval to take over a North Shore health system, this city of more than 90,000 would lose its only hospital — and quick access to care. Lynn, among the poorest and most diverse communities in the state, would also become one of the largest without its own hospital.
“It’s almost a civil rights issue,” said Mary Ellen Palermo, a longtime Lynn resident working with a grass-roots group, Union Hospital Advocates, to preserve the hospital. “They’re taking services away from the neediest area and giving it to communities that already have the means.”
Union Hospital, which has served Lynn for more than a century, is a key component in an elaborate plan by Partners to acquire hospitals in Medford and Melrose, consolidate services north of Boston, and cut costs by an estimated $300 million over five years. Partners, the biggest and most expensive health care provider in the state, already owns Union and Salem Hospital in Salem, which it operates together as North Shore Medical Center.
Under the plan, which still needs state approval, Lawrence Memorial Hospital in Medford would become a short-stay facility, while Melrose-Wakefield Hospital in Melrose would be renovated and continue as a full-service hospital. Partners would move medical and surgical services from Lynn to Salem, investing about $190 million to expand Salem Hospital, and up to $40 million to convert Union Hospital to a primary care and behavioral health center, serving patients who struggle with dementia, drug addiction, depression, and other mental illnesses.
“We’ve been working to try to figure out how to get that right care in the right place,” said Dr. Gary L. Gottlieb, chief executive of Partners. “This overall vision works very well together.”
But many in Lynn say not for them. In addition to their frustrations about losing medical services, some residents are worried about what could happen when Lynn becomes Partners’ regional hub for mental health services.
“To drag people from all over the region and plop them here in a single-family neighborhood — that to me is putting an undue burden onto people who are already really vulnerable,” said Dale Orlando, a retired psychologist, who lives a quarter-mile from the hospital in a quiet neighborhood near the Lynnfield border. “A vast number of people who are mentally ill and substance abusers are also homeless. I think we’ll see more people on the streets and taking up residency in the woods.”
Like other old industrial cites, Lynn confronts many social and economic challenges, from poverty to crime to high unemployment. The jobless rate in Lynn, just below 7 percent, is more than a point above the state average. Median household income, about $44,000, is one-third below the state median of nearly $67,000. One in five people in Lynn lives in poverty, nearly double the statewide poverty rate.
Union Hospital supporters say the relocation of medical services would be a burden especially for the poor and elderly, who don’t drive or have cars to make the roughly 6-mile trip to Salem. While familiar doctors, nurses, and other staff from Lynn will be transferred to Salem, some residents worry they will lose the sense of community they experienced at Union Hospital. Others are concerned that Salem will become too crowded, leading to delays for people who need care.
Some seniors even fear that in the event of an emergency, the longer ride to Salem could be the difference between life and death.
The effort to save medical services at the hospital has gathered support from ordinary citizens, local officials, congressional candidates, and others. Hundreds have displayed lawn signs or bumper stickers. Thousands have signed petitions
Community hospitals around the country have closed, or merged with larger systems, as admissions decline and public and private payers shrink and restructure reimbursements. Meanwhile, state and federal health care overhaul laws are increasing pressure on hospitals to control costs.
Partners executives, who promise to keep Union’s emergency room open after moving other services to Salem, say the changes are necessary for the system to succeed in an environment where care is shifting to outpatient clinics, and hospitals are reserved for the sickest patients in need of specialized treatment.
Union Hospital, they say, isn’t busy enough to maintain specialty services — like interventional radiology, neonatal care, and thoracic surgery — so those services are best consolidated in Salem.
“You just can’t do that at two sites that are this close together,” said Robert G. Norton, chief executive of North Shore Medical Center, which operates the Salem and Lynn hospitals and has been losing money in recent years. “We’re trying to fit the needs of the new world that we live in. This is about reorganizing how we deliver care with a major commitment to expanding access, to delivering primary care.”
Salem Hospital already serves more Lynn residents than Union does, Norton said.
Boston-based Partners has a network of more than 6,000 doctors and owns several hospitals, including the world-renowned Brigham & Women’s and Massachusetts General hospitals. As it has attempted to grow and reorganize its services in response to state and federal health care laws, Partners has provoked concerns from competitors, regulators, and consumer advocates who worry its market dominance will lead to fewer choices and higher costs.
In addition to Hallmark Health System, which operates Lawrence Memorial and Melrose-Wakefield hospitals, Partners is trying to acquire South Shore Hospital in Weymouth. Attorney General Martha Coakley reached an agreement with Partners that would limit its future growth but allow it to acquire Hallmark and South Shore. The settlement still needs court approval.
Partners is simply responding to the changing health care landscape, said Steven Tringale, chief executive of the Boston consulting firm Tringale Health Strategies.
“There’s a reduction in demand for the traditional inpatient service mix that all community hospitals provided,” said Tringale, whose firm has done work for Partners and its competitors. “What Partners is proposing quite frankly makes a lot of sense.”
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