Health

HEALTH • Summer 2018 17 began 50 years ago at Memorial. "It was two totally different cultures," Cox said of Memorial's history as a community hospital, and UMass' history as a teaching hospital. "For too long, we were two differ- ent silos," she said. "Those at Memorial felt like they were being taken over by UMMC, and the UMMC felt like they were being taken over by Memorial," added Tosi, whose career started at Hahnemann. "Now, most aren't from one of those formative institutions. They came after the merger." 81 Hope Ave., Worcester, MA 01603, 508.983.6790, massccn.org Your Community Partner For children, adults, and seniors with complex lifelong needs, MCCN's experience and commitment helps them coordinate their health and well-being, and improve their quality of life. Contact 508.983.6790, or email info@massccn.org, today! H UMass Memorial Medical Center $19,800,000 1.3% $60,100,000 3.9% $47,600,000 2.3% HealthAlliance Hospital $3,900,000 2.4% $7,000,000 4.2% $8,200,000 3.4% Marlborough Hospital $2,900,000 3.6% $4,600,000 5.7% $8,900,000 8.2% Clinton Hospital $200,000 0.6% -$1,200,000 -4.6% -$2,300,000 -9.5% STATE ACUTE HOSPITAL AVERAGE 4.2% 3.7% 2.6% Total Total Total profit/loss Margin Profit/loss Margin profit/loss Margin 2014 2015 2016 UMass Memorial Health Care hospitals by the budget: Note: Profit/loss rounded to nearest hundred thousand. Source: Center for Health Information and Analysis In the past few years, Lowell General Hospital and Tufts Medical Center combined under a new com- pany called Wellforce, and then added Melrose-Wakefield Hospital and Lawrence Memorial Hospital. In a much larger potential merger, Beth Israel Deaconess and Lahey Health of Burlington await approvals from the Health Policy Commission and the state attorney general. Mergers today are often a response to price pressures from the Affordable Care Act, as the way reimbursements are made to hospitals has changed, said Paul Hattis, an associate profes- sor of public health and community medicine at Tufts University School of Medicine. Recent years mark a second wave of mergers after the 1990s, when insurers started getting an upper hand in price negotiations with providers, spurring hospitals to merge in order to gain purchasing power, he said. "The evidence isn't yet there that we're getting that much more quality" from hospital mergers, Hattis said. "But what we do get is high prices. It remains to be seen that it's all going to work out." Even financially viable smaller hos- pitals remain susceptible to takeovers, analysists said. Still, some indepen- dent hospitals remain in Massachusetts, and they appear to be surviving well. Most of them, includ- ing Harrington Hospital in Southbridge and Milford Regional Medical Center, have been profitable in each of the last three years. Anniversary a chance to look back Memorial Hospital joined UMass only months after UMass teamed up with HealthAlliance, which owned hospitals in Leominster and Fitchburg that themselves merged in 1993. UMass' bid was chosen over a larger one by Tenet Healthcare, which owns Saint Vincent Hospital and MetroWest Medical Center. HealthAlliance's hospitals joined to a growing UMass roster that already added hospitals in Clinton and Marlborough in 1995. With Memorial Hospital on board, the UMass Memorial Health Care network was official. The HealthAlliance and Memorial mergers with UMass were complete within one month of one another in early 1998. For Tosi, whose medical career in Worcester started in 1977, the 20-year anniversary of the system offers a chance to look back on changes to Worcester's health care industry. At the start of Tosi's career, he said, Worcester had seven hospitals: UMass, Memorial, Saint Vincent, Worcester City Hospital, Hahnemann, Doctors Hospital, and Fairlawn Hospital. By the late 1980s, Hahnemann and Memorial merged with Holden Hospital. Worcester City Hospital's former campus is now Community HealthLink, a UMass-affiliated treat- ment center. Doctors Hospital is now AdCare Hospital, which offers addic- tion treatment services. Fairlawn is now a physical rehabilitation facility. Community HealthLink and Fairlawn are both affiliated with UMass Memorial Health Care, and the Hahnemann campus has outpa- tient services for UMass. What are now UMass' University and Memorial campuses have finally felt more like one in recent years under the tenure of Eric Dickson, the president and CEO of UMass Memorial Health Care since 2013, said Debbie Cox, the manager for intra-hospital transfers at UMass Memorial Health Care, whose career

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