David Torchiana has a lot on his plate in his first days as chief executive of Partners HealthCare. Among them: calculating just how much power and influence the state’s premier health organization still has in Massachusetts.
Torchiana said Partners has pulled back its plan to merge with Hallmark Health System — owner of hospitals in Medford and Melrose — until further notice, after stiff public resistance scuttled its merger deal with the bigger and more important South Shore Hospital.
“Hallmark, I think, is still very interested in a future that involves merging into our system, but . . . we’re certainly not going forward with that in the immediate future,” Torchiana said in a conversation last week. “We’re going to try to assess it and figure it out and make a plan what to do.”
Partners is a group of hospitals, including Massachusetts General and Brigham and Women’s, and a large physician organization that has wielded much clout in the medical world for the past two decades. Torchiana, a cardiac surgeon known far and wide as Torch, led the physician group at Mass. General before taking the top job at Partners on March 2, at a time when that clout faces unprecedented resistance.
That doesn’t mean Partners has been sidelined. Last week it acquired a group of about 70 doctors who practice mainly on the South Shore.
Just days earlier, Massachusetts’ new attorney general, Maura Healey, had criticized that pending transaction but said she didn’t have any legal grounds to oppose it.
And it was Healey’s opposition to the South Shore Hospital merger that proved to be a big turning point, dealing Partners a rare setback that Torchiana now describes as a “live and learn” experience.
“I learned that the acquisition of a major hospital is not something that is politically feasible in the current environment because of this intense consciousness about cost management,” he said.
Torchiana thinks much of the ongoing public debate about limiting medical costs greatly oversimplifies a complicated issue. In Massachusetts, he said, it often boils down to a conclusion that Partners is the real problem and containing it is the primary solution.
“I don’t think that logic train is actually valid, but it’s the playbook a lot of people are operating from,” he said.
The Torchiana playbook sees lots of different things contributing to a cost problem that defies any single solution.
He also doesn’t consider the cost of medical care in Massachusetts so far off the chart — given the cost of doing business in Greater Boston and the relatively high income of patients in the area, compared to the rest of the country.
The Partners approach to costs revolves around big new information systems to better keep track of patients and their care. It also involves more treatment in suburban settings.
Torchiana doesn’t think much of the idea that all Partners wants to do is gobble up smaller hospitals so that it can dominate the health care market even more.
“I don’t think our market strength flows from acquisitions,” he said.
At Partners, in his view, the real market power rests in the quality and reputation of its famous academic medical centers in Boston.
I never saw greater market dominance as a real objective of the Partners hospital merger plans. But it certainly would have been a consequence of the deals of the scale Partners was considering.
In fact, we’re in the midst of a medical merger wave unmatched in at least two decades. Steward Health Care has grown that way. So has Beth Israel Deaconess Medical Center and Lahey Health. Partners saw similar opportunities — particularly the chance to reach into Boston’s suburbs to the south — and struck its own deals.
A year ago, approval for Partners mergers seemed like a sure thing. But two things in particular, the tenacity of its opponents and the election of a new attorney general, helped to create the new environment Torchiana talks about.
So what’s his view now?
“We’ve gotten a clear understanding of the limits of something like the South Shore acquisition,” he said. “I don’t think we know what the limits are around lesser actions.”
Trust me, Torch, you’ll find out soon enough.