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Signature in talks with Beth Israel

Brockton group would drop Tufts

By Robert Weisman
Globe Staff / August 3, 2012
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Trustees at Signature Healthcare in Brockton have decided to open exclusive talks with Boston’s Beth Israel Deaconess Medical Center about a clinical affiliation, a move that would result in Signature dropping its two-year-old partnership with Tufts Medical Center.

The negotiations, disclosed in a memorandum from Signature president Kim Hollon to its medical staff chiefs, are the latest sign of the bare-knuckled competition raging as the Massachusetts health care industry consolidates. Signature owns 253-bed Brockton Hospital along with Signature Medical Group, which employs 150 doctors and has 550 affiliated doctors.

Hollon’s memo, obtained by the Globe, said company officials were “very excited by the vision and strategy outlined by Dr. Kevin Tabb,” the new chief executive of Beth Israel Deaconess. It said Signature officials began reassessing their Tufts affiliation at the start of this year “amid numerous and dramatic changes unfolding within our market place.”

While the memo did not specify those changes, Brockton Hospital’s crosstown rival, Good Samaritan Medical Center, was among a half dozen Catholic hospitals in Eastern Massachusetts acquired in 2010 by for-profit Steward Health Care System. Steward has been upgrading the hospitals it bought and aggressively expanding the chain’s physicians network. In recent months, it has wrested groups of doctors from Beth Israel Deaconess, Partners HealthCare System, and Tufts.

Tufts, a Tufts Medical School teaching hospital in Boston, recently aligned with a group of Hyde Park physicians that formerly worked with Steward. And in the fall of 2009, MetroWest Medical Center, which runs hospitals in Framingham and Natick, switched its clinical affiliation to Tufts from Beth Israel Deaconess, a Harvard Medical School hospital.

“There’s a lot of chaos and frenzy as well as opportunity in the market right now,” said Ellen Lutch Bender, president of Newton health care consulting firm Bender Strategies. “This is an example of an affiliation strategy in a pool of other potential affiliations between community hospitals and academic medical centers. The market is in a state of competition at a high pitch as hospitals organize to provide high-quality, low-cost, sustainable health care.”

Marie Gross, vice president of business development for Signature, said a steering committee weighed affiliation proposals from more than a half dozen prospective partners — both community and teaching hospitals, in Massachusetts and out of state — before deciding to enter into exclusive negotiations with Beth Israel Deaconess. “We’re moving through the negotiating process, but these talks will last at least several months,” Gross said.

Until a final deal is reached, she said, Signature will remain aligned with Tufts. “We’ve had a very good relationship with them, and we hope that we’ll work with them in one form or another in the future,” Gross said. Even if it switches to Beth Israel Deaconess, the Brockton health care organization will retain its pediatric relationship with Tufts Floating Hospital for Children, she said.

Beth Israel Deaconess does not have a comparable pediatric arm.

“There’s been a lot of realignment of medical groups and hospitals,” said Gross, citing the rise of integrated health care systems known as accountable care organizations. “So we felt we had to review our strategic positions. Beth Israel presents tremendous opportunities in terms of specialty services, teaching programs, and their strategic view, which is similar to ours.”

Gross stressed that Signature wants to remain independent and is interested only in a clinical affiliation, not a full merger such as those that resulted in the Beth Israel Deaconess community hospitals in Needham and Milton.

Many details remain to be worked out, including whether Signature doctors would be included in the Beth Israel Deaconess physicians group that bargains with health insurers — which could give them greater market clout.

One factor that gave Beth Israel Deaconess an advantage over Tufts was its longstanding ties to Bridgewater Goddard Park Medical Associates, a Brockton doctors group affiliated with Signature and Brockton Hospital. The group refers patients to the Boston hospital for more complex care.

“We’re very pleased about this,” said Beth Israel Deaconess senior vice president Judy Glasser. “It’s part of our strategic direction. We have a good network of community hospitals and we’d like to expand that.”

Brooke Tyson Hynes, vice president for Tufts Medical Center, said the Signature move was “not unusual” in the current environment. “It’s a rapidly changing market, but there’s lots of opportunities for us out there,” Hynes said. She cited Tufts’ ongoing alliances with MetroWest, the Heart Center of Metro West cardiology group, and Jordan Hospital in Plymouth as well as Lawrence General, Lowell General, and Morton Hospital in Taunton for pediatric care.

Brockton has long benefited from two community hospitals. But it’s unclear whether a partnership with Beth Israel Deaconess could strengthen Signature’s Brockton Hospital as a competitor to Steward’s Good Samaritan.

“Anything that preserves access to local care is good for the community,” said Chris Murphy, spokesman for Boston-based Steward.

Robert Weisman can be reached at weisman@globe.com.

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