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Boston Capital

Health care alternative

By Steven Syre
Globe Columnist / June 29, 2010

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One of the many economic hot-button issues influencing health care involves famous Boston teaching hospitals expanding beyond their city limits deep into the suburbs.

Does that bring top-flight medicine to more patients where they live or turn higher-cost health care into another form of suburban sprawl? The question doesn’t come with simple black and white answers.

But here’s a little news: Beth Israel Deaconess Medical Center will announce today that it has created an affiliation with Commonwealth Hematology-Oncology PC, a private practice of 24 doctors who treat cancer patients from offices in eastern Massachusetts. The practice, commonly known as CHO, operates from a dozen offices but maintains comprehensive cancer centers with expensive radiation equipment in Weymouth and Newburyport.

An affiliation is not a takeover. CHO will remain independent but rely on Beth Israel’s resources as needed for very specialized high-end care like bone marrow transplants and have access to a greater range of clinical trials for its patients. “This is a very patient-centric thing,’’ says Michael Anderson, the president of CHO and one of its doctors.

But both Beth Israel and CHO take pains to emphasize a “commitment to economic responsibility’’ in their affiliation.

That means at least two things. For one, the price of routine treatment for CHO patients will remain the same, which is to say, cheaper than Boston teaching hospital rates. Anderson also points out that the new affiliation isn’t breaking ground on new buildings or planning any other major capital expenses.

That second point highlights a key distinction between the Beth Israel affiliation and an $89 million cancer center built last year on the campus of South Shore Hospital, less than 2 miles by car from the longstanding CHO cancer center in Weymouth.

The Dana-Farber/Brigham and Women’s Cancer Center at South Shore Hospital is as impressive as it sounds, from both a medical and a marketing point of view. Think of an original Broadway cast replacing the touring company for a stop in suburbia. Who wouldn’t want to go?

State public health officials warned four years ago that new cancer cases would outstrip the existing resources of hospitals to treat them. They urged hospitals to build expensive new facilities and the new Weymouth center is one among several that have emerged since.

“Our doctors and clinicians were proud to be able to respond to the needs of cancer patients in the area,’’ said Rich Copp, a spokesman for Partners Healthcare, the parent firm of Brigham and Women’s.

But the South Shore ended up with two cancer centers separated by a five-minute drive, each with lots of resources and expensive hardware like linear accelerators, the equipment used in radiation treatment.

Irony alert: Partners has opposed Beverly Hospital’s plan to open a $10 million radiation treatment center on the North Shore as an “unnecessary duplication of a very expensive service.’’ It would operate within 5 miles of a Partners cancer center in Danvers.

Back on the South Shore, Dana-Farber officials insist the two cancer facilities in Weymouth are not in the same league. “I don’t think there’s any comparison,’’ said Larry Shulman, Dana-Farber’s chief medical officer, ticking off a long list of highly specialized services offered on the South Shore Hospital site. “They have a nice center, they have good docs. But I just don’t think it’s even close.’’ This is a good spot to mention that the CHO practice is highly thought of in oncology circles and the biggest community-based cancer practice in the state. Many of its doctors, including Anderson and CHO chairman Jack Evjy, a past president of the Massachusetts Medical Society, are well regarded.

But the CHO doctors surely would be operating from a disadvantage without their new Beth Israel alliance. In the future, their resources will be much more evenly matched, and two very different business models will compete to treat cancer patients.

“This isn’t to say one is right and one is wrong, but the one we feel more comfortable with is the way we’re doing it,’’ said Paul Levy, the CEO of Beth Israel. “We’ll see, in a way there will be a market test, won’t there?’’

There will be more market tests than you can count in health care over the next few years. This will be one to watch.

Steven Syre is a Globe columnist. He can be reached at syre@globe.com.