Friday, June 11, 2021

May Flower: The Bain of Hospitals

Who doesn't want private equity controlling the health care $y$tem?

""Bain Capital buys controlling stake in major New England urgent-care chain; ConvenientMD plans to add at least 300 jobs a year over the next few years amid expansion" by Jon Chesto Globe Staff,  May 12, 2021

Bain Capital has reached a deal to acquire control of the fast-growing ConvenientMD urgent-care center chain, with plans to add hundreds of jobs annually for the next several years as Bain expands the group’s New England footprint.

The Boston private equity firm is buying the controlling stake in the Portsmouth, N.H.-based health care firm from Starr Investment Holdings, through its Double Impact fund, for an undisclosed amount. The deal, signed last week, is expected to close within the next 45 days.

Gareth Dickens, co-founder of ConvenientMD, said he plans to use Bain’s investment to help foster continued growth of the 26-clinic business, which generated about $105 million in revenues last year. Dickens expects to open as many as nine clinics this year, and 10 per year after that. At that pace, he expects to add at least 300 employees a year to the company, which currently employs about 1,200 people including physicians and other direct health care providers. The next clinics to open in Massachusetts will be in Burlington, Dedham, Ludlow, and Westborough.

Dickens plans to focus on contiguous areas within the three states that the company does business — Maine, New Hampshire, and Massachusetts — though it’s possible the company could expand into other New England states as well.

Dickens launched ConvenientMD in 2012 with Max Puyanic, a former colleague of his at investment bank William Blair & Co. Their goal: to provide a low-cost alternative to emergency rooms, but with many of the same services. For example, ConvenientMD offers lab services and digital imaging, which are among the services it offers that aren’t available at many of the urgent-care centers that have popped up in the region in recent years.

“We recognized that New England had a massive gap,” Dickens said. “There’s a fairly broken primary care system, with overworked [doctors] carrying thousands of patients. The patients who can’t get in [to see their primary care providers] fast enough end up using the emergency room for care, which is massively expensive.”

[The way the Globe tells it, telehealth fixed all that before the AI monitoring takes over]

Dickens said ConvenientMD’s clinics “look like a lot of emergency rooms” but charge health insurers one-fifth to one-tenth of the price. The company began to grow quickly once Starr invested in 2018. Bain’s acquisition will help that growth to continue.

Peter Spring, a managing director at Bain, said his firm was particularly impressed with how ConvenientMD rose to the challenge during the COVID-19 pandemic, offering a range of treatment and testing options. Bain’s Double Impact fund makes investments in health, education and workforce development, and sustainability businesses that can deliver competitive financial returns and measurable social and environmental benefits.

[Greatly helping to Re$et things, if you will]

“Being able to provide that full scope of services with an easy entry point for people really does improve access to care,” Spring said.

Bain is also expanding in Japan, along with Carlyle Group and KKR, as the competition heating up among the world’s biggest private-equity firms keeps them hopping.


What do you mean they closed the emergency rooms?


They are also laying off staff?

"Lawrence General Hospital cuts staff, citing COVID-19 losses" by Priyanka Dayal McCluskey Globe Staff, May 25, 2021

Lawrence General Hospital, the community hospital for a city ravaged by COVID-19, is laying off 56 people and is threatening additional cuts unless it receives immediate government aid.

[Extortion is also an illne$$]

The layoffs include employees working in administration and patient care and amount to about 2.5 percent of the hospital’s workforce.

Financial challenges are not new to Lawrence General, which serves a large proportion of low-income residents on MassHealth, the state Medicaid program, but chief executive Deborah Wilson said she has never witnessed the hospital in such a crisis.

Lawrence General entered 2020 with financial losses, and the situation worsened through the pandemic as the hospital halted non-essential care — losing millions in revenue — and focused almost entirely on patients sick with coronavirus.

[Who played God and decided was was "non-essential" as untreated cancers and conditions are now killing more people than the CVD fraud?]

“We were weak going into COVID, and now we’re weaker coming out of COVID,” Wilson said. “It’s an unsustainable situation.”

The hospital is seeking an infusion of government aid: $10 million from federal officials and $25 million from the state. Otherwise, Wilson said, it will have to slash more spending to remain in compliance with bondholders. (The hospital has bond financing from MassDevelopment.)

“This is going to impact services this community desperately needs, like maternity and pediatrics and the things that it’s hard for me to imagine that we wouldn’t have here at Lawrence General,” Wilson said.

[More people dying unnecessarily to the glee of certain psychopathic monsters]

Hospitals in the state received more than $2 billion in aid through the federal CARES Act in 2020, and more funding this year, but Lawrence General hasn’t qualified for a payment since last summer. The hospital received $44 million from the federal government and $17 million from the state last year — but that has not been enough, Wilson said.

[Who cares if the government used most of the money for itself its bureaucracy?]

The hospital spent more on supplies, including personal protective equipment, during the pandemic, and while COVID-19 hospitalizations have fallen, Lawrence General still is not seeing the number of regular patients it saw before the pandemic. These challenges, hospital officials said, are in addition to a longstanding concern: that the state doesn’t reimburse them enough for providing care to patients on MassHealth.

[No one trusts the death mills anymore, and one wonders if this is an unforeseen consequence. The sick psychopaths pushing this whole shebang thought we would all be rushing into their arms in gratitude when we are running away from them as fast as we can and don't dare go near them]

The hospital and its affiliated doctors network lost $19 million on operations, on revenue of about $300 million in the fiscal year that ended Sept. 30.

Last week, S&P Global Ratings noted Lawrence General’s “highly vulnerable” financial situation and downgraded its credit rating to B- from B.

Lawrence, where people of color make up 85 percent of the population, has been especially hard hit by COVID-19. About 21 percent of the city’s residents live in poverty, according to US Census data.

Since the start of the pandemic, 1 in 4 Lawrence residents — or 20,000 people — have been infected with COVID-19.

Residents who became seriously ill ended up at Lawrence General, where at one point last spring, more than 100 of the hospital’s 186 beds were filled with COVID-19 patients. The number of COVID-19 patients surged again after the winter holidays.

State health officials on Tuesday did not indicate whether they would send more aid to Lawrence General. They’ve already provided tens of millions of dollars in support to the hospital, “in addition [to] working with them on their longer term fiscal situation,” said Brooke Karanovich, spokeswoman for the Executive Office of Health and Human Services.

Juana Matias, a former state representative from Lawrence who now serves on the hospital board, called on state officials to do more.

“We have not been funded adequately by the state,” she said. “The state is quick to talk about health disparities and inequities, but they’re not funding a community hospital like Lawrence in the way it needs to be able to serve the people who live here.”

“If we don’t receive these remedies,” she said, “the situation is only going to worsen.”


Welcome to the "new normal" at the hospital:

"A year into COVID-19, hospitals find a new normal" by Priyanka Dayal McCluskey Globe Staff, April 20, 2021

After battling COVID for more than a year and weathering two surges of sick patients, Massachusetts hospitals are settling in to a new normal.

They’ve shifted from managing a raging crisis to incorporating COVID into their daily work. For the foreseeable future, hospitals expect to continue treating COVID patients — though the number could rise as variants spread or fall as more people get vaccinated.

Hospitals across the state are treating about 700 COVID patients, 23 percent in intensive care, even as the economy reopens and more than 2 million people in Massachusetts are fully vaccinated.

Massachusetts hospitals are not as strained as hospitals in some other parts of the country — such as Michigan, which is in crisis again — but they have no plans to close their COVID units anytime soon.

Hospitals must remain prepared in case the contagious new variants — and a pandemic-weary public letting down its guard — lead to another spike in infection and illness. Already, the number of people testing positive for coronavirus and the number sick enough to be hospitalized ticked back up in late March and early April, after falling since January.

[Using a faulty technique that doesn't detect infectiousness to detect a virus that doesn't exist. 

Yeah, I am weary of this flop]

Hospitalizations in Massachusetts now appear to be on a plateau.

“We just need people to hang on just a little bit longer until we can get prevalence of the virus down to low levels and get vaccination rates up well north of 50 percent — closer to 70, 80 percent,” said Dr. Paul Biddinger, director of emergency preparedness for the Mass General Brigham hospital system.

[Yeah, two weeks to flatten the curve that never was until cold and flu season comes around again, with the ultimate goal to get the whole population vaccinated when they don't need it.

What a MONSTER!]

Hospitalizations in Massachusetts soared to their record high a year ago, when 3,965 COVID patients were in hospital beds. During that first surge, hospitals curbed almost all non-emergency care and redeployed staff to manage the influx of patients sick with the virus.

After ebbing during the summer and early fall, hospitalizations increased again amid the winter holidays. Now, they’re busy trying to manage COVID and non-COVID care at the same time.


Once-unfamiliar protocols are now the norm. Patients are tested for the coronavirus before scheduled procedures and upon admission to the hospital. Visitors are restricted. Personal protective equipment, especially masks, is commonplace. Social distancing is required.

“The new normal is just managing [COVID] as part of our routine operations,” said Dr. Ravin Davidoff, chief medical officer at Boston Medical Center, where about 20 people are hospitalized with COVID. Over time, he said, he expects to see fewer COVID patients.

[I would rather die then]

Since the virus first emerged last year, the profile of the typical COVID patient has changed. Seniors, who largely are vaccinated, no longer make up the majority of people hospitalized with COVID. Patients now tend to be younger, in their 30s, 40s, and 50s, said Dr. Kevin Tabb, chief executive of Beth Israel Lahey Health.

“We’re concerned there’s a younger population that has stopped taking precautions . . . and think that if they get sick, it will be mild,” he said. “I would not discount the potential for young people to get very, very sick because we see that every day.”

[F***ing liar]

Doctors and nurses know much more about how to treat the disease than they did last year, but they are exhausted from more than a year of the physically and emotionally draining work.

The trajectory of the pandemic remains tricky to predict. Variants of the virus are known to be circulating in Massachusetts, but data on their prevalence are limited.


There is njo pandemic, never was one!]

“It’s really hard to predict what’s going to happen,” said Dr. Sarah Haessler, hospital epidemiologist at Baystate Medical Center, where about 50 patients are being treated for COVID. “These variants are really a wild card.”

Haessler called the month of April “a really critical inflection point” in determining the course of the pandemic, as variants spread and more people get the vaccine.

Through the course of the pandemic, hospitals have become used to adding beds for COVID patients when numbers rise, and closing makeshift units when numbers fall. It’s a delicate balance: creating enough space to manage COVID patients while maintaining as many of their other services as possible.

On Cape Cod, where the P.1 variant has contributed to a mini-surge in infections and hospitalizations in recent weeks, Cape Cod Healthcare is running two COVID units, one in Hyannis and one in Falmouth, with a total of 36 beds, said Michael Lauf, the chief executive.

Those COVID units have been busy, but Lauf said he expects hospitalizations to gradually fall again. If needed, Cape Cod Healthcare could double the number of beds available for COVID patients.

“Where we are is where we’re going to be — with or without vaccines — at least for the remainder of the next six months,” Lauf said. “COVID is going to be with us. We’ve all learned to adapt.” 

[What a laugh, in this case a bitter and sardonic sneer!]

They will still treat you on an outpatient basis:

"An ambitious plan by Mass General Brigham to expand into affluent suburbs miles from Boston has set off a fight about the future of outpatient health care in Massachusetts. A group of rival health care companies has mounted an opposition campaign to block the expansion plan, worried that the state’s biggest health care provider will become even more powerful at their expense. They argue that Mass General Brigham’s plan to build outpatient surgery centers in Westborough, Westwood, and Woburn will encroach on the turf of important community health care providers and raise costs for the state by drawing patients away from these less expensive providers. Mass General Brigham officials dismiss the criticism as grievances from competitors working to protect their own interests, and insist their project will provide high-quality and cost-effective care that patients need and want. “If it provides a positive benefit to patients,” spokesman Rich Copp said, “it should be approved,” but critics say that if Mass General Brigham gains market share, particularly among wealthier patients, local providers will lose critical revenues. “The MGB expansion is on a size and a scale that’s unprecedented. It’s going to change the landscape of health care should it go forward,” said Thomas A. Shields, chief executive of Shields Health Care Group, whose imaging and surgery centers compete with Mass General Brigham. “The question is: Is there a need in the community?” Shields said. “Those areas are already being well served.”

Are you, citizen?

"Massachusetts General Hospital is pushing forward with a massive $1.9 billion project to build two new towers as part of its effort to focus on treating the sickest patients at its downtown campus, remaking a critical corner of Boston and potentially boosting public transit. The project is part of a broader strategy by the hospital’s parent company, Mass General Brigham, to move more routine care to community hospitals and outpatient settings, and free up space for the sickest and most complicated patients at MGH, a Harvard-affiliated academic medical center that is ranked among the top hospitals in the country...."

Also see:

All part of the bubble.