Partners HealthCare is the biggest employer in Massachusetts, and its flagship hospitals are world-renowned for their high-quality medical care and groundbreaking research.
But back home, among local political leaders, Partners has a target on its back.
As it defends its turf on Beacon Hill, the sprawling nonprofit organization has become the largest corporate spender on lobbying firms over the past year-and-a-half. During that time, Partners spent some $840,000 on outside lobbyists, including $303,000 in the first half of 2017, according to records kept by the Massachusetts secretary of state’s office.
“As the region’s largest health-care system and largest private employer, we have the responsibility to ensure that our patients, our caregivers, and our employees have a voice on important health-care issues that could impact them,” Partners spokesman Rich Copp said.
Boston-based Partners’ concerns include a series of political moves to control health-care costs by essentially imposing penalties on medical institutions that charge higher rates for their services. The two Partners flagship hospitals, Massachusetts General and Brigham and Women’s, have been particularly vulnerable.
In 2016, the health-care union SEIU Local 1199 pushed a ballot question that would have redistributed hospital revenues, a measure that could have cost Partners nearly $450 million a year. Intense political negotiations resulted in a compromise that dropped the ballot question in favor of establishing a legislative commission to study price variations among the state’s hospitals. That commission created more work for Partners’ lobbying team — and many other health-care players, for that matter — with a series of suggestions released in March to control costs and modify health plans.
Also in early 2017, Governor Charlie Baker proposed imposing price caps on the state’s most expensive hospitals, which could have cost Partners tens of millions of dollars in lost revenue. That provision was dropped during budget negotiations in the Legislature in the spring. But a similar concept emerged this fall when the state Senate leadership proposed a cost control bill that particularly targeted Mass. General and the Brigham.
The Senate passed a version earlier this month, but the House will not take up the issue until next year, all but ensuring more rounds of lobbying for Partners.
Paul Hattis, associate professor of public health at Tufts University School of Medicine, said it’s understandable that Partners would be a big spender on lobbyists, with those threats looming at the State House.
“That certainly creates some pressure for Partners to have to worry about legislative or regulatory changes that could impact their revenue flow,” Hattis said. “Their response to that is to invest in lobbying.”
Partners has a four-person, in-house government relations team led by Joe Alviani, who plans to retire at the end of this month. The in-house lobbyists also spend a significant amount of time working at the federal level, where funding related to the Affordable Care Act and the National Institutes of Health has come under attack.
In Massachusetts, the team turns for help from three well-connected lobbyists: John Sasso, a former top political aide to Governor Michael Dukakis; Dennis A. Smith, a former top state official in the 1980s; and Henri Rauschenbach, whose previous career as a Republican state senator overlapped with Baker’s time as a top aide in the Weld and Cellucci administrations.
Lobbyist spending often reflects the most pressing issues before the Legislature and state regulators. Last year, for example, Spectra Energy was No. 2 behind Partners as it pursued plans for a big pipeline project.
Always a big issue on Beacon Hill, the increasing cost of medical care has made the current period of political debate especially fertile ground for lobbyists who focus on that field.
Close behind Partners in spending on outside lobbyists through the first half of 2017 are the Massachusetts Biotechnology Council and Steward Health Care.
The bill recently passed by the state Senate, for example, includes new requirements for the pharmaceutical industry — measures that would affect local biotech companies that make treatments with breathtaking prices. The Senate bill could also raise rates at lower-cost hospitals.
So it’s probably not surprising that the largest spenders in the state on lobbying, when in-house staffers are factored into the equation, are the Massachusetts Health & Hospital Association and the Massachusetts Association of Health Plans. The hospital group has seven lobbyists on staff and the insurance group has nine, helping both organizations to spend more on Beacon Hill than Partners in the first half of this year.
“Our legislative and regulatory activities are commensurate with the number of issues we’re dealing with,” said Eric Linzer, executive vice president at the health insurers’ group. “Obviously, over the last couple of years, there’s been a lot of activity.”