Massachusetts delegation flags new concerns over Steward-Optum deal; some suggest the State take them over

• Colin A. Young

Nearly every member of the Massachusetts Congressional delegation signed onto a letter sent Friday to the heads of Steward Health Care, UnitedHealth Group and Optum Health casting serious skepticism that Optum’s purchase of the floundering Steward’s physician network will benefit the Bay State.

A slew of state and federal lawmakers have raised concerns with a potential sale of Stewardship Health to for-profit insurer Optum since it was announced about four weeks ago. But in Friday’s letter spearheaded by U.S. Rep. Lori Trahan, eight of nine member of Congress from Massachusetts specifically said they are worried that UnitedHealth is seeking to acquire Steward’s physicians to offset lower operating margins at Optum, “potentially compromising the autonomy of physicians who may be pressured to prioritize efficiency over personalized care.”

“The absorption of doctor practices is part of a vast, accelerating consolidation of medical care, leaving patients in the hands of a shrinking number of giant companies or hospital groups,” the letter, signed by every member of the delegation except U.S. Rep. Richard Neal of Springfield, said. It later added, “There is also a worry that Optum may direct patients from the expanded physician network to its own urgent care or surgery centers, potentially disregarding what is best for patients.”

The proposed deal would involve the sale of Stewardship Health Inc., the parent of Stewardship Health Medical Group Inc., which employs primary care physicians and other clinicians across nine states, to OptumCare, a subsidiary of UnitedHealth Group.

The letter asks for specific information about the proposal, including the number of new physicians Optum will acquire in Massachusetts if the sale is completed, the amount of money Optum will pay for the Stewardship network, what portion of the proceeds will be used to pay off Steward debt, whether any of the proceeds will be reinvested into Massachusetts hospitals, how patient data will be protected, whether physicians affected by the sale will continue to practice in the same insurance networks, and more. The lawmakers asked for responses by next Friday, April 26.

A Steward spokesperson did not have a response Friday afternoon and Optum’s spokespeople did not immediately respond to News Service outreach.

The Health Policy Commission, whose job it is to monitor health care spending growth, plans to review the proposed sale to, among other things, “understand which Steward physicians are involved in the transaction, and what the relationship will be between the physicians and Steward’s hospitals,” according to a presentation given to the commission’s board last week. But the agency said it did not have the documents necessary to begin its 30-day preliminary review.

An HPC spokesperson said Friday that the agency “has begun examining the proposal based on available information, however, key information from the parties is still outstanding.” The filing that triggers the 30-day clock on the HPC’s review cannot be completed until the HPC gets “the definitive agreement and other requested information and documents,” HPC Communications Director Mickey O’Neill said.

Once that filing is complete, O’Neill said the HPC will have 30 days to determine whether to conduct a more comprehensive review, known as a Cost and Market Impact Review (CMIR), of the transaction. The proposed sale cannot be completed until “after the HPC’s review and any concurrent review by state or federal antitrust authorities,” O’Neill said.

MassCare, which pushes for single-payer health care, announced a series of rallies to be held next week as it calls for Steward’s hospitals to remain open in Massachusetts. State government and hospital operators have begun talking about what could happen, and what contingencies could be enacted, were any Steward hospitals to close imminently.

“Many have suggested that the State of Massachusetts use its power of eminent domain to take over the hospitals and once again run them as public hospitals. An idea worthy of immediate debate!,” Executive Director Kimberley Connors wrote in an email.