Tufts Medical Center and Lowell General collaborate on new health care system

Tufts Medical Center (MC) and Lowell General Hospital have finalized an agreement to create a new health care system, Wellforce, to provide more integrated and coordinated care to patients at both hospitals, according to an announcement last month.

In an Oct. 22 press release, CEO of Lowell General Normand Deschene said that Wellforce “turns the traditional health care model on its head” by focusing on prevention, community health and investment in technology, instead of solely on hospital equipment and buildings.

Deschene first proposed the idea of an affiliation in September 2013. The proposal was a response to a changing health care landscape in light of the Affordable Care Act, according to CEO Emeritus and Vice Chair of the Tufts MC Board of Trustees Ellen Zane, who will also serve as chair of the Wellforce board. 

“Wellforce is aligned with the revolution occurring in health care,” Deschene said in the statement. “The ACA and trends in health care costs in the United States demand a new vision for care delivery.”

Deschene’s vision was different than most hospital mergers and affiliations occurring today, Zane explained.

“He noticed in the market that most hospitals, usually big hospitals, acquire little hospitals,” she said.

Zane said an academic hospital such as Tufts MC would usually do the same, but Deschene suggested a more egalitarian relationship between Tufts MC and Lowell General.

The two hospitals have similar numbers of beds, and Tufts MC has a longstanding history of providing specialized services at Lowell General, according to Zane. She said both Tufts MC and Lowell General are ranked as high-quality facilities on every parameter used to measure health care quality and are ranked as more cost-effective than other hospitals of the same caliber. Deschene envisions the two hospitals integrating care and reducing costs.

Though Wellforce now owns Tufts MC and Lowell General, both hospitals will retain much of their organizational autonomy. The primary difference in care is that Tufts MC will now provide higher-level services in Lowell “so people can get the care they need closer to home,” Zane said.

Zane said the affiliation has a perspective on providing care that differs from most hospital relationships: it focuses on patients and doctors as the central aspect of care rather than hospitals. She said this perspective will focus on keeping people healthy and out of hospitals.

“The paradigm shift for us is saying, let’s think of this as concentric circles with patients and doctors in the middle, and everything else circling around that as tools to help keep patients in the best shape they can be in from a health care standpoint,” Zane said.

The affiliation will also improve both hospitals’ abilities to provide patients with seamless, high-level care at a lower cost, according to Zane.

“If a patient needs something we can only provide at [Tufts MC], let’s say a transplant -- we will be able to work especially closely with Lowell, so that the patients and the doctors all talk to one another and work with one another,” she said.

The Massachusetts Health Policy Commission (HPC), which monitors changes in the health care marketplace and uses a 30-day review period to analyze the potential effects of changes in hospital ownership, determined that the affiliation under Wellforce would not likely raise costs. David Seltz, executive director of the HPC, says it might  might actually save patients money.

“Both [Tufts MC and Lowell General] have relatively low prices compared to their peers,” he said.

The HPC also concluded that the affiliation will likely result in more patients being referred to Tufts MC rather than more expensive hospitals in downtown Boston, Seltz noted.

Seltz added that unlike in other situations the HPC has reviewed, Tufts MC and Lowell General are not direct competitors. When competing hospitals merge, Seltz said, costs often rise, but this would not be the case with Wellforce.

Zane said she was glad the HPC made the decision that it did. She believes regulators in Massachusetts such as the HPC are looking at Wellforce as a prototype for the future of health care.

“The idea is not for providers to come together and raise costs … it’s for providers to come together so they can provide care better and therefore reduce costs to create value,” she said.

In the future, Wellforce aims to bring other hospitals under its purview, and Zane said they have already begun talking with some provider groups about becoming a part of Wellforce.

“We think there are a number of community hospitals and physician groups out there in eastern Massachusetts that will find this model attractive,” she said.