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Saint Vincent & MetroWest Medical Center appear safe from Tenet Healthcare's hospital divestment BY EMILY MICUCCI Worcester Business Journal Staff Writer T he third largest contributor to the flurry of hospital mergers and acquisitions in 2017 – the biggest year for hospital deals in a decade, according to consulting firm Kaufman Hall – was Tenet Healthcare Corp., owner of Saint Vincent Hospital in Worcester and MetroWest Medical Center in Framingham. But while Dallas-based Tenet has sold nine hospitals since August, and said it will sell four more, the pub- licly traded company has made no suggestion it will offload its Massachusetts holdings – its only hospitals in the Northeast, which it bought in a 2013 acquisition of Tennessee-based Vanguard Health Systems. Focusing on the core market Massachusetts remains part of Tenet's core market, said Senior Vice President Dan Waldmann, even as the healthcare system had announced plans to divest hospitals in Texas, Chicago, Philadelphia, Missouri, and the United Kingdom, to help pay down its $15-bil- lion debt. e system also restructured its corporate operations, eliminating a regional management layer, and is exploring the sale of Conifer Health Solutions, its healthcare business services segment. Coinciding with these developments has been great- er investment in ambulatory care centers, which have grown tremendously for Tenet since the acquisition of United Surgical Partners International, another Texas company, in 2015. In buying a majority stake in USPI, Tenet more than doubled the number of ambulatory care centers it owns, to 460 as of this month. e ambulatory care side is important, because sys- tems can perform surgeries more efficiently outside of hospitals, where emergency events impact patient flow, and where overhead costs are higher. e hospital business is still central to the Tenet strategy, of course. It is the third largest for-profit hospital operator in the U.S., according to Becker's Hospital Review, with 69 hospitals as of April, though the number will decrease to 68 when the planned sale of a St. Louis hospital is complete. Rather than get out of the acute-care hospital busi- ness in order to focus on outpatient care, CEO Ronald Rittenmeyer, told healthcare media outlet Modern Healthcare in January the system is divesting hospitals not fitting its core business. Tenet wants to operate hospitals in the top one or two acute care providers in their markets, which is certainly the case in Greater Worcester, where Saint Vincent is the smaller of two, behind UMass Memorial Medical Center. e lines are blurred a bit for MetroWest Medical Center, which has campuses in Framingham and Natick and competes with Greater Boston providers. But Tenet has invested in surgery programs there and inked a key clinical affiliation with Boston-based Beth Israel Deaconess Medical Center in Boston in 2016 to make MetroWest Medical Center a more attractive option for people seeking clinical services in the Boston suburbs. ose investments are something Jeffrey Welch – CEO of Saint Vincent Hospital and group CEO of Tenet's Massachusetts and South Carolina hospitals – noted in an interview earlier this month. Welch joined Saint Vincent in April 2017 when former CEO Steven Saint Vincent Hospital CEO Jeffrey Welch sees Tenet Healthcare's investment in its two Central Massa- chusetts facilities as a good sign they will avoid the parent company's divestment efforts. Core hospitals 10 Worcester Business Journal | April 16, 2018 | wbjournal.com PHOTO/MATT WRIGHT