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State panel hears more about the pros, cons of L+M Hospital affiliating with Yale

New London — A panel from the state Office of Healthcare Access heard Tuesday from supporters of having Lawrence + Memorial Healthcare join the larger Yale-New Haven Health System, and from those who fear the affiliation will undermine local control of the hospital, reduce medical services and force patients to drive longer distances for more expensive care.

Maritza Bond, executive director of the Eastern Connecticut Area Health Education Center, spoke about a patient's experience at Windham Hospital after it became part of the larger Hartford Healthcare network.

A woman in her early 50s suffered a stroke and needed care, Bond said.

But the hospital didn't have a neurologist on site and had to transfer the woman by helicopter to Hartford, Bond said.

The woman also spoke another language, but no translation services were available to her or her family. "There was no way to effectively communicate with this patient," Bond said.

The woman's family ended up traveling more than 30 miles to be at her side, Bond said.

The state board is considering both the application for the affiliation and a related application for L+M to transfer ownership of its affiliated physician group, L+M Medical Group, to Northeast Medical Group, Yale-New Haven's physician organization.

Both applications were submitted in October.

L+M Chief Executive Officer Bruce Cummings said the affiliation is needed to protect and expand patient care services, not cut them. 

The hospital is projected to lose $22 million this year, and the board of trustees has already had "very difficult" conversations about services, Cummings said.

"The absence of this affiliation will put a number of services in jeopardy," he said. He declined to say which ones might be cut.

Marna P. Borgstrom, chief executive officer of Yale New Haven Health, said it's in the system's interest to strengthen member hospitals.

She said Yale seeks to add physicians the community needs, such as primary care doctors, maternal and child health physicians and some surgical specialists.

"This is to recruit physicians who can meet those needs in the community that are not being met now," she said. "It's for new providers."

But Dr. Stephen Smith, a family practice physician in New London, said the savings that mergers are supposed to create often don't materialize and local care suffers.

"In my opinion, hospital mergers can only be justified if there are no other available options to save a financially distressed hospital," he said.  "And we know from publicly available documents that L+M operates in the black and is not financially threatened."

Others raised concerns about the cost of care.

"We know that an emergency room visit to Lawrence + Memorial costs $631, and to Yale-New Haven Hospital $1,162," said Columbia Business School Professor Fred Hyde. "The average outpatient surgery at L+M costs $2,609, compared to $6,262 at (Yale)."

"Twenty percent of families in New London live below the federal poverty line," said Lisa D'Abrosca, president of the registered nurses' union at L+M. "The last thing our community needs right now is to pay more for their health care."

On Monday, Senate President Martin M. Looney, D-New Haven, urged regulators not to move forward with the review of the proposed merger until they have pricing data from Yale.

"It is my understanding that Yale New Haven Hospital has refused to provide the requested information and is claiming that risk-adjusted prices do not exist, and that if they did exist, Yale New Haven Hospital would refuse to provide them because they are proprietary," Looney said in a prepared statement.

"The claim that the data does not exist lacks credibility," he said.

Looney said the board should not approve the application without the data.

d.straszheim@theday.com 

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