South County Health president voices concerns over Lifespan-Care New England merger

The merged entity would control 80 percent of the market -- a potential problem for smaller health care systems in the state.

The Andrew F. Anderson Emergency Center at the Rhode Island Hospital, one the largest hospitals in the state.Jonathan Wiggs/Globe Staff

WAKEFIELD, R.I. — The chief executive of South County Health said the organization has concerns about the proposed Lifespan-Care New England merger.

Aaron Robinson told attendees on a public Zoom meeting Thursday evening that the nonprofit company, which includes South County Hospital in Wakefield, was having conversations with elected officials, the attorney general, and others in the state about the merger.

“Obviously, that is a major shift in the market and major news story on the horizon, as it relates to health care in Rhode Island,” said Robinson. “The way I would describe our position on this merger is, at a high level, we do have some concerns on this merger.”

Robinson said that while he believes that this proposed merger, also called by advocates as the “Rhode Island solution,” addresses some components of health care in Rhode Island, but not all.

“Rest assured we are advocating strongly for all protections for South County Health, no matter what comes out of this potential merger,” Robinson said.

On Feb. 23, Rhode Island’s two predominant health care systems, Lifespan Corporation and Care New England Health System, announced that they had signed a definitive agreement to merge and create an integrated academic health system with Brown University. Brown had committed to providing a minimum of $125 million over five years in support of the development of the integrated health system — and earned the university a position on the governing board of the newly merged system.

This latest deal is the fourth time the two health care systems have attempted to merge since the 1990s. Since talks first began three decades ago, observers have noted that the deal could increase access to care for consumers, while critics say the merger could lead to less competition in Rhode Island’s condensed market, job cuts, and a possible increase in overall health care costs and health insurance premiums. Executives at both systems have denied these claims over the years.

Robinson on Thursday night echoed some of the concerns from critics.

“Though the talking points suggest quality would improve as these two health systems come together, really, the body of evidence suggests that when two organizations come together and create a monopoly of 80 percent market share, many times the opposite occurs,” Robinson said. “Quality erodes, and patient experience erodes.”

And if 80 percent of the market was owned by one system, there could also be downward pressure on wages because people would have fewer alternatives for jobs, Robinson said.

Robinson called South County Health a “quality leader” in Rhode Island. He said it does have “strategic alternatives,” but did not elaborate on what those were.

“We do want to be a part of the solution,” he said. “We do want to have those ongoing conversations.”

Robinson said he believes the proposed merger will receive “significant federal scrutiny.”

If Lifespan and CNE were to merge successfully, the newly formed entity could very well become the state’s biggest employer. The application that the two systems will soon submit, which is likely going to be thousands of pages long, will need to gain approval from the Federal Trade Commission, the Rhode Island Department of Health, and the state attorney general’s office.

While the FTC gave the systems the green light on a merger attempt in Dec. 2007, the commission will likely be the application’s biggest regulatory hurdle because of how mergers and acquisitions among American hospitals have increased costs and caused layoffs in the last decade.

Joseph Wendelken, spokesman for the state’s health department told the Globe recently that while the systems may have an initial submission of their application, the health department will still have to deem it complete. After that, the state would post the materials of the application online for the public.

When asked how long it would take for the health department to deem an application complete, Wendelken said a timeline can’t be provided until the application is submitted.

South County Health includes the hospital, which has 100 beds, as well as South County Home Health, South County Medical Group, and South County Surgical Supply.

Combined, Care New England and Lifespan dwarf South County. Lifespan’s Rhode Island Hospital alone has more than 700 beds.

“Certainly, in its current configuration, we believe any 80 percent market provider could have negative impacts on smaller health systems within that same market,” Robinson said. “And we’re expressing those concerns while still trying to have a productive conversation about alternative solutions.”