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Lifespan, Care New England revise merger application with R.I. regulators

The attorney general told the Globe Monday that the application left several key questions unanswered

Rehabilitiation technician Chelsea Abbenante holds the hand of a COVID-19 patient on a ventilator inside the intensive care unit at Kent Hospital in Warwick, a Care New England facility.David Goldman/Associated Press

PROVIDENCE — The executives at Rhode Island’s two largest health care systems have revised and resubmitted their Hospital Conversion Act application at the request of regulators. The application seeks approval of a proposed merger between Lifespan Corporation and Care New England Health System.

For decades, Lifespan and Care New England have been competitors in a relatively small market. They’ve attempted to merge several times in the past, with no success. But after mounting pressure from former governor Gina M. Raimondo’s administration and ramifications from the COVID-19 pandemic, the two came together again with a vision for a word-class integrated health system, in partnership with Brown University’s Warren Alpert Medical School.


The health care systems announced Monday that their applications to state regulators and to the Federal Trade Commission were resubmitted on Friday after the FTC, the Rhode Island attorney general’s office, and the Rhode Island state health department had follow-up questions about applications that were submitted in April.

The attorney general’s office told the Globe Monday that the merger application had not yet been deemed complete. Attorney General Peter Neronha told the Globe in an interview that in every hospital conversion application, the office provides a set of questions to the systems.

“The first round of responses, in our judgement, did not fully answer the questions,” said Neronha, who said it’s “not unusual” for the office to ask the systems to revise their responses for a deal “of this magnitude.”

His said his office will decide whether the application is complete by Nov. 16.

According to Neronha, the questions his office was seeking answers to included: “What is this new entity, if approved, from their perspective, going to look like? Where would it be? Where would it operate? What kinds of services in those places? Would they not provide services in other places?”


He said for his office to evaluate how the Lifespan-Care New England merger would impact Rhode Island, he would need to know the effect it would have on the quality of care, the cost of care, and the accessibility of care. He said he also needs to understand Brown’s role in the deal.

Once his office is able to start the review process, which cannot happen until the application is deemed complete, there could be one of three outcomes: approved as proposed, approved with conditions, or not approved at all.

“It’s very difficult to evaluate those three critical pillars — accessibility, affordability, and quality — without actually fully understanding what the proposed entity would look like,” said Neronha. “That’s the kind of information we’ve been asking them to provide to us so we can do that analysis.”

“If it’s approved or approved with conditions, then it needs to be in the best interest of Rhode Islanders. If it’s not, it’s not going to be approved,” he said.

Eight months ago, executives signed a definitive agreement to merge. In the definitive agreement, Brown had committed to providing a minimum of $125 million over five years in support of the development. Brown will participate on the governing board of the newly merged system and play a key role in integrating medical education and research with clinical practice across the combined system’s hospitals.

“We anticipate completing responses to the FTC’s information request over the coming weeks, having submitted many thousands of pages of information to the FTC to date, with more to come,” wrote Raina Smith, a Care New England spokeswoman, in a press release Monday.


Dr. James E. Fanale, president and CEO of Care New England, and Dr. Timothy J. Babineau, president and CEO of Lifespan, would not answer questions from the press. But in an exclusive interview with The Boston Globe in July, the two confirmed that they were looking to complete all the necessary filings to all regulatory parties by “mid-to-late September.”

Lifespan owns the Rhode Island, the Miriam, Hasbro Children’s, Newport, and Bradley hospitals and is known for its work in neurology, cardiology, orthopedics, pediatrics, and cancer treatment and care. Care New England owns Women & Infants, Kent, and Butler hospitals and has expertise in family medicine, obstetrics, gynecology, neonatology, and adult psychiatry.

Executives said previously that they hope the integrated system will have a full array of complementary medical specialties and biomedical research to remain on the leading edge of treatment and therapies, according to the announcement.

Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.